HIPPY Interest Form

∗ HIPPY Interest Form ∗

If you are interested in applying for the HIPPY Program, please click on the following link to send in your contact information. 

→  https://forms.gle/14fT9eRERc8iKWNV6 

Thank you for your interest in the HIPPY Program! 

 

A HIPPY staff member will contact you soon to complete the application process and request the following documentation: 

     - Parent's drivers license 

     - Child's birth certificate

     - Child's social security card

     - Medicaid eligibility letter (if applicable) 

     - Income documentation (if not eligible for medicaid)