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Central Florida
GOALcfl Assistance Fund Application
First name
Last name
Phone Number
D.O.B
Please provide a brief explanation of why you’re requesting assistance, including the resources you’ve already utilized and any other organizations you’ve contacted.
Kindly provide a list of the other organizations you’ve contacted, along with the outcomes of those interactions.
LGBTQ+ Status
Is this an Emergency?
Employment Status
Employer
Have you received prior assistance from GOALcfl? If so, provide the date.
Address
Amount Requesting
Email
If you're going through a rough patch due to being out of work, let us know how many jobs you've applied for and any contact you've had with employers.
Were you referred?
If you're requesting assistance for repairs, please provide three estimates. List the names of the service providers below along with their quoted costs.
Upload Copies of Estimates
Upload File
Submit
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