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COVID Assistance Care Packages Application

  1. Contact Information
    You will receive a confirmation and contactless pick up time and day by email. It is important that you contact us if you are unable to make the pick up time provided and arrange an alternative date/time. Please be aware that these care packages are for City Residents Only.
  2. Childrens facemasks are also available so please indicate the number of children and adults
  3. How would you like to receive your care package*
    Please pick one
  4. Leave This Blank:

  5. This field is not part of the form submission.