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Lorenzo Legacy Thanksgiving Basket Form  2022

Did you receive holiday assistance from Lucian Hunter Foundation of Hope last year?*

Select an option

Are you applying for Christmas assistance too? Please note, you will need to fill out a separate application form for Christmas.*

Select an option

Please complete all information below. Please complete all information below. You must be a Virginia resident and submit required documents to participate.

General Assistance TANF AMOUNT *

Monthy Income *

FOOD STAMP MONTHLY AMOUNT *

Total household income *

Please complete all information below. You must be a Virginia resident and submit required documents to participate.

Adult 1

Adult # 2

Mailing Address:*

City*

State:*

Zip Code*

Phone*

Email Address*

Number of Family Members:

Please complete all information below. You must be a Virginia resident and submit required documents to participate.*

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