Legacy Harvest Foundation- Financial Assistance Application-2022

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1.Have you experienced a hardship in 2022?
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2.Are you currently employed?
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3.Please provide your zip code in Georgia?
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4.Do you rent a home or an apartment?
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5.Is the place you need assistance with your primary residence?
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6.What is the total number of people who reside in this household?
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7.Have you or individuals in your household qualified for unemployment benefits?
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8.Are you or members or your household experiencing homelessness or housing instability?

If so, have you experienced the following?

*Has received a rental eviction notice.
*Has received past due utility or rent notice(s).
*Experiencing a housing cost burden.
*Forgoing or delaying the purchase of food, prescription meds, childcare, or similar essential necessities.


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9.What type of assistance are you requesting?
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10.What is your name, email, and phone number?
Current Progress,
0 of 10 answered