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Get and Sign Printable Liheap Application  Form 2012

Get and Sign Printable Liheap Application Form 2012

Use a Printable Liheap Application Form 2012 template to make your document workflow more streamlined.

LIHEAP Agency? (circle) Yes No If yes, which agency provided assistance?_______________________________________________________________ Applicant Name: Telephone: Cell: Current Address: City: State: Zip: City: State: Zip: County: Mailing Address (If different from Current Address): LIST ALL HOUSEHOLD MEMBERS (INCLUDING APPLICANT). USE ADDITIONAL PAPER IF YOU NEED MORE SPACE NAME (must provide first and last name) Applicant Name: MARITAL STATUS RELATIONSHIP TO...
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Music hi I'm Katie, and I'm going to show you how to fill out your application for the childcare assistance program when you first look at the application page two is going to be the parent or guardians general information your name address phone number there are a couple questions in here that you can answer email address your date of birth the primary language is spoken in your home and what county you reside in, and then it does ask if you have more than one child care provider for this application page three of application is going to be list your work information you're going to need to list the employer school name your job title the address city and state the phone number the date that you started the job and then your income information how much you make per hour per month or per year how often you get paid how many hours a week you work how many days a week you work and then your travel time to and from the childcare provider to work and then there's a question that asks if yo

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