Furniture Program Intake
Referral to Feed My Sheep.
Electronic Signature
At the end of this form, you will be asked to type your name as an electronic signature.

By doing so, you certify that, under penalty of perjury and false swearing, your answers are correct and complete to the best of your knowledge, including information provided about the citizenship, income, or alien status for each household member applying for benefits.
Name of Organization Referring (if applicable)
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