Beaumont Middle YSC Sharing Thanksgiving Form/Programa de Servicios Especiales 
Once again the Thanksgiving Holiday is fast approaching.  Sometimes due to life circumstances families are not able to provide a Thanksgiving meal for their family. The Beaumont Middle School Youth Services Center attempts to work with these families to link them to God’s Pantry for a special Thanksgiving meal basket.  

If your family would benefit from a Thanksgiving Basket this year, please submit this form to the Youth Services Center Office by Friday, September 23, 2022.   I will not be able to accept incomplete or late applications.  Feel free to contact me at 859-381-3107 or betsy.fusilier@fayette.kyschools.us if you have any questions.

*Eligible candidates will receive a letter in the mail from God’s Pantry with additional pick up information.*  

Pick up location: Southland Christian Church, 2349 Richmond Road, Lexington, KY 40502.   
Pick up dates: November 21st and 22nd

Household Eligibility Requirements - Fayette County Residents - 
Clients must meet the following income requirements: 
Household Size___ Income Per Month 
1..................$1,473 
2..................$1,984 
3..................$2,495 
4..................$3,007 
5..................$3,518 
6..................$4,029 
7..................$4,541 
8..................$5,052 
Each additional family member + $512  

Thank you!

Si su hijo(s) recibe almuerzo gratis, el/ella califica para recibir la canasta de comida gratis para el Día de Acción de Gracias. Firme y devuelva esta hoja a la Sra. Waters, Directora del Centro de Servicios para Jóvenes.  Si tiene preguntas o necesita más información, contacte a  Betsy Fusilier a 381-3107 o betsy.fusilier@fayette.kyschools.us.  

REGRESE ESTA SOLICITUD a la Sra. Fusilier ANTES DEL 23 DE SEPTIEMBRE 2022.

*Las personas que califican, recibiran una carta en el correo por parte de "God’s Pantry" (el banco de comida) con más información sobre su canasta de comida *


Dias para recoger su comida: Noviembre 21 y and 22nd
Lugar para recoger: Southland Christian Church,
2349 Richmond Road, Lexington, KY 40502.


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Name (First and last) of head of household in the home (18+ Up) Please include BIRTHDATE   *  Nombres completo y fecha de nacimiento de todos los adultos que viven en su casa. *
Gender of adult #1 (Head of household) /  *Género del 1er adulto (Cabeza de casa) *
Ethnicity of adult #1 / Etnia del primer adulto *
Name of next adult in household PLEASE include birthdate (Adult #2 in home). Nombre y fecha de nacimiento del 2ndo. adulto en casa.
Gender of adult #2. Genero de 2ndo. adulto
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Ethnicity of adult #2 *Etnia del 2ndo. adulto
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Name of next adult in household PLEASE include birthdate (Adult #3 in home) Nombre y apellido del 3er adulto en casa.
Gender of adult #3 / Genero del 3er adulto
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Ethnicity of adult #3 *Etnia del 3er adulto
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Child (ren) at BMS (List all names - first and last - and grade) * Nombre, Apellidos y grado de su(s) estudiante(s) en BMS.  *
# Adults in Household *  Número total de adultos en casa  *
# Children in Household * Número total de niños   *
Address * Dirección: *
Phone Number * Número de teléfono: *
Pick up location: Southland Christian Church, 2349 Richmond Road, Lexington, KY 40502.   Pick up dates: November 21st and 22nd * Lugar para recoger: Southland Christian Church, 2349 Richmond Road, Lexington, KY 40502. Dias para recoger su comida: Noviembre 21st and 22nd *
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