Legacy Harvest Foundation- Financial Assistance Application-2023

1.Have you experienced a hardship in 2023?
2.Are you currently employed?
3.Please provide your zip code in Georgia?
4.Do you rent a home or an apartment?
5.Is the place you need assistance with your primary residence?
6.What is the total number of people who reside in this household?
7.Have you or individuals in your household qualified for unemployment benefits?
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.

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