Waxahachie CARE does not and shall not discriminate on the basis of race, color, religion, gender, gender expression, age, national origin, disability, marital status, sexual orientation, or military status, in any of its activities or operations.
ALL INCOME MUST BE PROVIDED AND MAY BE VERIFIED. IF INCOME IS LATER FOUND THAT IS NOT DISCLOSED, BENEFITS MAY BE SUSPENDED OR DENIED.
Please read: I confirm that the information provided is complete and correct to the best of my knowledge. I am also aware that any attempt to obtain aid fraudulently from Waxahachie CARE will result in my application being denied and services suspended. I understand that any and all information supplied by me on this form may be verified. Tax Return may be requested to verify income. I give my permission to CARE to share information with other agencies and utilities, if necessary.
This application does not guarantee that CARE can assist with your needs.
I also agree to allow Waxahachie CARE to perform the following actions:
1. Use my demographic information in monthly statistical reports, county and city reports.
2.Contact past and present employers to verify my employment status.
3. Contact my apartment manager/landlord, utility providers or any other contact to verify my situation.
4. Contact other social service agencies on my behalf to network my efforts in receiving assistance.