Holiday Assistance Appointment Request
Once you complete this form, a Mary Rigg staff member will reach out to you to make an appointment. This form is ONLY to request an appointment and does NOT register you as a participant nor does it guarantee that you are signed up to receive assistance.
Street Address Line 2
State / Province
Postal / Zip Code
My household participated in the 2019 Holiday Assistance Program
How did you learn about this program?
Word of Mouth
Should be Empty: