Instructions:

1. Begin by filling out the Head of Household Information section. This includes your name, address, phone number, date of birth, and Social Security number.
2. Next, complete the General Household Information section. This includes information about all the members of your household.
3. In the Income section, fill out all fields related to your household's income. This includes employment income, self-employment income, and any other sources of income you receive.
4. Lastly, in the Household or Medical Expenses section, provide information about any medical or childcare expenses your household incurs each month.

All required fields will be marked with a red asterisk. Please fill out as much information as possible, as this will help to speed up the SNAP application process when we call you over the phone.

Thank you for taking the time to fill out the Client Pre PEAK form and for considering Hunger Free Colorado as a resource.