GRACEPOINTE FOOD BOXES

Welcome!
We’re so glad you’re here. This form helps us serve you better and stay in touch if you’d like. Please complete each question carefully.
¡Bienvenidos!
Nos alegra mucho que esté aquí. Este formulario nos ayuda a servirle mejor y mantenernos en contacto si así lo desea.
Por favor complete cada pregunta con cuidado.
Date

Total number of People in Household/ NUMERO TOTAL DE PERSONAS EN EL HOGAR *
Total Number of Children 17 years old or younger/ NUMERO TOTAL DE NINOS DE 18 ANOS O MENOS ENEL
HOGAR
Total number of Seniors(60) years old or older in household /NUMERO TOTAL DE PERSONAS MAYORES DE 60 ANOS O MAS EN EL HOGAR

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