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Fresh Bucks Wait List Application

Fresh Bucks helps Seattle residents afford fruits and vegetables.

7 of 14 Tell Us About Yourself

Please enter your first and last name

(US and Canada only)

Please enter your email address

Do you receive mail at a different address than your home address?

Some answers on this page need to be fixed

This page of your application either has some errors or some fields were left blank. If you continue to the previous page, none of the information entered on this page will be saved until the errors are corrected.