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Apply for Assistance

Do you know a family, or are you in need of our help?


Please complete this gift request. The maximum is $800, and a copy of the bills or invoices must be submitted with the request.

You can upload up to 2 different PDF bills you would like Blaze of Hope's assistance with. If you have trouble using this form or have different file formats you can email your bills to

Upload File
Upload File
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