JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Topeka Family Legal Project Application
For residents of Shawnee County, Kansas
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Applicant's Name:
*
Your answer
Applicant's personal pronouns:
She/her/hers
They/them/theirs
He/him/his
Other:
Clear selection
Applicant's Date of Birth:
*
MM
/
DD
/
YYYY
Current Mailing Address:
*
Your answer
Phone Number:
*
If this number is not your personal telephone, please provide the name of the person or business whose telephone number you enter.
Your answer
How many children under 18 live in your home under your care?
*
0 - I don't have Children
1
2
3-5
6+
How do you prefer we communicate important information to you?
*
Best way to contact:
Email
Phone Call
Text
Other:
Required
What is the main legal issue you are requesting help for?
*
Housing
Education
Public benefits appeals - my benefits were terminated unfairly or my application was denied
Expungement of criminal conviction
Guardianship of a child
Collections - I am being sued/harassed for a consumer or medical debt
Other:
Next
Page 1 of 5
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
