Hello - UCITY Family Zone is a non-profit organization with the mission of empowering communities to increase opportunities and improve the quality of life.  We are working to ensure that families in this community have access to the services and resources needed to stay physically and emotionally healthy during this difficult time. Please let us know your needs and how we can serve you.

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* 1. Contact Information

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* 2. How many dependent children live in your household?

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* 3. What school (s) do your children attend?

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* 4. What is your yearly household income?

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* 5. Are you currently:

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* 6. What is your occupation: 

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* 7. Do you need assistance with childcare while you are at work?

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* 8. How many adults older than 18 years live in your house (including yourself):

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* 9. Do you have a regular source of health care?

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* 10. Do you need a referral to a food pantry to help with groceries?

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* 11. Are you able to pay your rent at this time?

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* 12. Do you need help paying other bills at this time?

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* 13. Would you be interested in volunteering in the community to help other neighbors?

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* 14. Have you completed your 2020 Census? It's important to complete it so that we are all counted and the city, county, and state will receive more funds for schools, transportation, hospitals, housing and also so we will have more political representation. The Census is secure.

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* 15. Please let us know if there are other areas or services that you need some help with: 

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