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CARES T.E.A.M. Services Request

  1. Norfolk CARES T.E.A.M. Services Request
  2. please enter the mm/dd/yyyy for your date of birth.
  3. Do you currently Live in the City of Norfolk?*
  4. Are you currently receiving SNAP benefits?*
  5. Are you currently receiving TANF benefits?*
  6. Are you between the age of 18-49 years old?*
  7. Do you have any children 0-18 years old on your SNAP case?*
    If you do not receive SNAP benefits, please select N/A
  8. Have you ever been convicted of a misdemeanor or felony charge*
  9. Are you a youth or young adult (age 17-24) who is transitioning out of foster care? *
  10. Are you a non-custodial parent with a Department of Child Support Enforcement case with TANF debt?*
  11. Leave This Blank:

  12. This field is not part of the form submission.