For each category, select the household member(s) that fit the scenario. If the category does not apply to anyone, check the No one box. In the Left Your Household section, select Yes or No.
The Pregnancy section only lists females who are older than 10 years old and younger than 60 years old. If someone in your home is pregnant but she is younger than 10 years old or older than 60 years old, you will need to inform the worker of this pregnancy during your interview.
The Special Needs section only lists household member(s) who are younger than 18 years old.
The Immunization section only lists household member(s) who are younger than 18 years old.
Click the Print button to print this page for your reference.
If you are applying for SNAP, FITAP, and or KCSP you may click the Complete button to navigate to the end of the application where you can review the rights and responsibilities, sign, and submit the application. Please note that if you are applying for Child Support Enforcement services all required fields must be completed before you can submit your application.
Click the Next button to save and continue with the online application.
Click the Previous button to view the previous page.
Click the Save & Exit button to exit the online application and save your progress on your application. The application is saved as Incomplete.