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Indigent Application

Applications can be e-mail with your proof of income to - family1952@aol.com

An Overview of the program is located Here

Proof of income is most recent 30 day bank statement, SSI or Disability award letter or most recent pay stub

All signature spots must be signed in ink or E-signature, they cannot be print. 

Indigent Application

Click on the graphic on the left to download the file.

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