38127 Community Fair 9/14-9/15

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Requirements for each of the vendors. Must pre-register for services – includes application & screening (September 1, 2018)

 
Bellevue Dental: (Friday and Saturday services September 14-15, 2018)
·         Recipient must not have dental insurance
·         Proof of residency (MLGW BILL, lease agreement, or mail with name)
·         Government issued ID
·         Must pre-register for services – includes application & screening (September 1, 2018)
·         (if a child under age of 18) consent from parents
o   Proof of Guardianship


 
University of Memphis Speech and Hearing (Friday, September 14, 2018 only)
·         Must pre-register for services – includes application (September 1, 2018)
·         In-take form must be completed prior to date of services


 
Sole Heaven Reflexology (Saturday, September 15, 2018)
·         Must pre-register for services – includes application (September 1, 2018)
·         Complete application prior to services


Lion’s Club (Saturday September 15, 2018 only):

·         Must pre-register for services – includes application (September 1, 2018)
·         Must provide proof of residency
·         Must have a screening performed on September 15, 2018


Susan B Komen (for first 30 participants)
·         Must pre-register for services – includes application (September 1, 2018)
·         Appointment for services on September 28, 2018 at Kingdom Fellowship Baptist Church “bruncheon” starting at 9:00 AM.

CSA Utility Assistance Only: (Friday September 14, 2018 tentative for September 15, 2018)
·         Must pre-register for services – includes application (September 1, 2018)
·         Required Documentation
o   Social Security Cards for each household member
o   Proof of birth for child 5 and under
o   Valid government issued identification
o   If a Veteran, proof of Veteran status
o   Proof of all household income for the last 2 months for all members 18 years of age and older
o   If a MHA recipient, tenant/owner notification of HAP/LEASE change
o   Public Housing HUD 59 Form
o   SSI, Social Security, Pension, Disability, and VA benefits
§  Current award letter
§  Current printout from Social Security Administration Office
o   TANF/AFDC Income
§  Current disposition printout from DHS
§  Current letter stating eligibility received by mail
o   Child Support
§  Current printout from Juvenile Court with gross amount collected monthly
§  If out of state award – legal court document with state seal
o   UI – Claim Summary
o   Employment
§  Previous or current check stubs from employer in dated numerical order
·         8 stubs if paid weekly
·         4 stubs if paid bi-weekly or semi-monthly
·         2 if paid monthly
§  Current letter verifying gross wages
·         Must be signed and dates
·         Must be on 8.5 x 11 company letterhead
o   Zero Income
§  Completed statement of Support (available upon request)
§  Written statement verifying zero income from friend or family member not residing in the home and who has not applied for LIHEAP assistance (must have contact number)
o   Self-employed
§  Self-written statement stating your company name, address, and phone number, social security number, expenses related to business (only), and net income for the last 2 months with signature
§  Most recent tax returns
o   Shelby County School Employee
§  Statement stating amount, hire date, hours worked per week, pay date and if employee is a 9, 10, or 12 month employee
§  Current check stubs.


 
 

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