Summer EBT Enrollment Form
Summer EBT Enrollment Form
Enroll eligible school-age children in the Summer Electronic Benefits Transfer (Summer EBT) program for grocery benefits during the summer months.
Parent/Guardian Information
Parent full name *
Your answer
Phone number
Email address
Mailing address
Preferred language
Children Information
Number of eligible children
+ 9 more questions
About this template
Enroll eligible school-age children in the Summer Electronic Benefits Transfer (Summer EBT) program for grocery benefits during the summer months.
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