Lakeside Community Resources
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Intake Application
Required fields are marked with an asterisk (*).
About You
First Name
*
Last Name
*
Email Address
How did you hear about us?
Friend or family member
A case worker or social worker
A flyer or poster
The website or a web search
Other
Please specify
Accommodations
Do you need any accommodations?
No accommodations needed
Wheelchair access
Language interpreter
Other (please describe)
Please describe your accommodation need
Submit Application