Christmas Giveaway
This holiday season MBK Village
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Housing Type *
What is your first name? *
What is your last name? *
Are you the Head of Household? If not, who is? *
What is your address? *
What is your zip code? *
What is your Date of Birth? *
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Total # of People in Household *
Are you Male or Female *
Phone Number
Number of Youth in Household *
Number of Adults in Household *
2020 Income Level *
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