https://newhopefamily.org/wp-content/uploads/videos/GroceriesonGod.mp4 Email* Name* First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Gender*FemaleMaleDate of Birth* PhoneAre you a member of New Hope?*YesNoPlease explain how you have been negatively impacted by COVID-19.*Please list all individuals living in the home.*How did you hear about this initiative?*Please select the benefits you are currently receiving*TANFSNAPNoneIf receiving , please state monthly benefits amountPlease select your current employment status.*I'm currently employedI'm currently unemployed and I have not applied for Unemployment benefits with Arkansas Division of WorkforceI'm currently unemployed and I have have applied for Unemployment benefits with Arkansas Division of WorkforcePlease provide a copy of the letter from Arkansas Division of Workforce Services if you have applied for unemployment benefits.If you have been laid off, please provide a letter from your employer documenting the layoff.