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Serving Livingston and surrounding areas
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Food Pantry Application
First name & Age
Last Name
Street Address
City
County
Region/State/Province
Postal / Zip code
Phone
Estimated Household Income:
Please list the names and
AGE(S)
of any additional people, that live at the above address.
Add answer here
Add answer here
Add answer here
The food pantry is required to ask the following in compliance with the Civil Rights Act of 1964. Your response is voluntary, please select your answer from the drop-down bar.
Choose an option
Choose an option
Submit Application
Thank you, we'll contact you asap.
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