By signing and dating this application, I permit the United Way of the Upper Ohio Valley to share my application information with the Belmont County Department of Job and Family Services so that eligibility for TANF financial assistance may be determined. Eligibility determination will be shared with the United Way of the Upper Ohio Valley who will make the necessary arrangements with the family to complete their shopping. Eligibility is based on 1. Must be a Belmont County resident; 2. Applicant must have an eligibility student(s) in their household; 3. A TANF assistance group composition must exist within the household; and 4. Applicant must be in receipt of Ohio Works First benefits, SNAP benefits, and/or Medicaid.