Get Help – Family Profile and Intake Form

Get Help

Little Dixie is here to help!  We offer a wide range of community assistance programs.  If you or a family member need assistance, please fill in the form below.  After submitting the form, someone from our office will get back with you with more details on how we can help.


                
  • Applicant Information

  • Please choose one or more types of assistance that you are looking for.
  • Amount Income Source  
       
    There are no Income and sources.
    Answering yes to this question will not disqualify you from any program assistance.
    Answering yes to this question will not disqualify you from any program assistance.
  • This field is for validation purposes and should be left unchanged.