Mollie's Meal Application Form

**In order to be eligible for Mollie's Meals Food Program you must Recieve:  VA  Benefits,  SSDI,  SSI,  have a Caseworker, Social Service Agency receive Federal Benefits OR  show  proof  of  a  financial  hardship  (ie:  Medical,  Loss of  income)
(Documentation  of  Benefits is  Required)

Mollie's Meal Application Form

**In order to be eligible for Mollie's Meals Food Program you must Recieve: VA Benefits, SSDI, SSI, have a Caseworker, Social Service Agency receive Federal Benefits OR show proof of a financial hardship (ie: Medical, Loss of income) (Documentation of Benefits is Required)

Nora Springs, IA USA