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Application
for Assistance
As funding is not sufficient to serve all
applicants at this time, we are asking that
those heads of households in need of assistance please add their
names to our waiting list below. The need is great for food and basic necessity assistance, therefore there is no guarantee as to how soon funding may become available and how soon we may be able to provide
assistance to each applicant. Clients with critical needs are served on a first-come, first-serve basis.
There is no need to contact us once your waiting list request has been submitted. We will maintain your records and contact you when, and if, funding becomes available. At that time, we will
confirm that your situation has not changed, re-evaluate your
eligibility, and ask you to complete a
comprehensive application, attaching supporting
documentation.
Our ability to serve those in need in a
timely manner is very dependent on receiving sufficient donations. A printable brochure can be accessed online on our volunteer page that explains our programs and services, and encourages
tax-deductible donations. Please feel free to print this and distribute to friends,
family, co-workers, and potential donors.
Thank you for your interest in the Legacy Health Foundation. Although we genuinely hope your situation improves in the interim, if it does not, we look forward to being able to provide you with the assistance you and/or your family may need, and to having you as one of our
future clients.
Household
Income Guidelines and Worksheet
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