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Project Share Registration 2020: Households with Children Age 18 & Under

Complete the form below to begin the registration process for Project Share in 2020.  After submitting the form, you will receive instructions to sign up for a confirmation phone call to complete your registration.  Important: Your registration is not complete until you complete the confirmation phone call.   If you have questions or need assistance, please call 651-437-7134. 


Project Share Registration for Households with Children 18 and Under
First Name
Last Name
Country
Address Line 1
Address Line 2
City
State
Postal Code
Phone
Combined monthly gross income for every adult in the household
Total Number of Household Members
Number of Adults
Number of Children
I am requesting:
Child #1
First Name
Last Name
Child #1 Age
/
/
Child #1 Relationship to Requesting Adult:
Child #2
First Name
Last Name
Child #2 Age
/
/
Child #2 Relationship to Requesting Adult
Child #3
First Name
Last Name
Child #3 Age
/
/
Child #3 Relationship to Requesting Adult
Additional Children
Please use this space for additional children. Please provide all information requested above for children #1-3.
I agree that everything written on this application is correct, true, and accurate. I understand that when I sign this I am giving Hastings Family Service permission to verify this information if necessary. I understand that I am requesting assistance from Hastings Family Service based on an emergency need and I agree not to receive holiday assistance from any other agency or resource. I understand that Hastings Family Service will deny, suspend, modify, reduce, or terminate future services if I provide untruthful or fraudulent information, if I receive holiday assistance from another source, or if I cannot demonstrate an emergency need.
I understand verification may be required upon Hastings Family Service request.
I understand that my registration is not complete until I complete the confirmation phone call. After submitting this form, I will receive an email with a link to sign up for a confirmation phone call.