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Recd ___ELECTRICAL & SERVICE ORDER FORM (Mail to: Convention Coordinator) 325 University Drive, P.O. Box 446 Hershey, PA 17033 (717) 5348604Fax: (717) 5348688Date___Ck. No. Amt.______PLEASE PRINT
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How to fill out crisis assistance application

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Go to the crisis assistance website or visit a local office to get the application form.
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Read the instructions on the form carefully before filling it out.
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Provide accurate and honest information about your situation
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Attach any necessary documents requested, such as proof of income or identification.
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Submit the completed application either online or in person, as per the instructions provided.

Who needs crisis assistance application?

01
Individuals or families facing financial hardship due to unexpected circumstances such as job loss, medical emergencies, natural disasters, or other crises may need crisis assistance application for help.
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Crisis assistance application is a form that individuals can submit to request emergency financial assistance in times of crisis.
Individuals who are facing financial hardship or crisis situations may be required to file a crisis assistance application.
To fill out a crisis assistance application, individuals must provide information about their financial situation and the nature of the crisis they are facing.
The purpose of a crisis assistance application is to request emergency financial assistance to help individuals overcome a crisis situation.
Information that must be reported on a crisis assistance application may include income, expenses, assets, debts, and details of the crisis.
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