I Need Assistance

I Need Assistance
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
How Can We Help You?
What county do you live in?
Ex: Fayette, Jessamine, Clark, etc.
Are you expecting or do you currently have a child age 5 or under?
Please note: Our Family Assistance Program provides items for families with children age 5 or younger. If you do not currently have a child age 5 or younger in your care, you are not eligible to receive items through this program. Verification of children is required.
Is it safe to leave voicemails?
Is DCBS involved?
Is there any history with domestic violence or Emergency Protective Orders (EPO's)?
Please type your question here:
Should be Empty: