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I understand that Wellesley Housing Authority staff will verify this information if applicable. APPLICANT SIGNATURE DATE PLEASE RETURN COMPLETED FORM MUST INCLUDE PROOF OF RESIDENCY AND INCOME VERIFICATION TO THE WELLESLEY FOOD PANTRY 207 WASHINGTON ST WELLESLEY MA 02481. 2017-18 REGISTRATION FORM Check one New Renewal Do you live in WHA Housing Yes No 207 Washington St Wellesley MA 02481 781 235-1188 PLEASE PRINT answer ALL questions complete BOTH sides and SIGN back of form Ms. Mrs. Mr....
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