INDIAN PEAKS BAND MEMBERS

PLEASE FILL OUT THIS APPLICATION BELOW

1ST QUARTER: JANUARY-MARCH

2ND QUARTER: APRIL-JUNE

3RD QUARTER:JULY-SEPTEMBER

4TH QUARTER: OCTOBER-DECEMBER 

**PLEASE LET US KNOW IF YOU NEED FOOD ASSISTANCE OR HOUSEHOLD EXPENSES** 

Adults must be enrolled member of the Indian Peaks Band of Paiutes