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B19932E9-FE37-4963-A46D-1EB7B1E32E2C.avif
Assistance Application
Multi-line address

Specify the Dollar Amount Needed

Please use the space above to explain why this support is needed and how funds will be used.

For requests that exceed $50, we require two references, which can be family members, sponsors, friends, healthcare providers, etc. Please provide names and phone numbers and/or emails for both references. We will contacted them to verify you are working toward sobriety.

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