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Certification/Recertification Questionnaire Date Name: Address: Complete the following information for your household and bring this questionnaire to your Initial Certification interview. A. Household
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How to fill out address - ebenezercares
01
Start by writing your full name at the top of the address form.
02
Next, write your complete street address, including the house/building number and the street name.
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If you live in an apartment or unit, include the apartment number on the same line as the street address.
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After the state/province, write the postal code or ZIP code.
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If you are filling out an international address, write the name of your country on the last line.
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Make sure to double-check your address for any spelling mistakes or missing information before submitting.
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If you are uncertain about any part of your address, contact your local postal service for assistance.
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