Recipient Application Form

You may view and download the form here. You have the option to send us an email with all the questions answered or a scanned copy of this form completed.

Tips

Before emailing us the form, please ensure that you have done each of the following:

• Complete all questions as necessary
• Check the accuracy of each answer
• Check your grammar and spelling to the best of your ability

We can only serve the cities of Los Angeles and Richmond, along with their immediately surrounding suburbs at this time.