Click here for a downloadable version of our application.
Once application has been completed, please feel free to fax or mail to the following:

Mailing Address:

OHIO
PO Box 6424
Akron, Ohio 44312
Phone: 330-733-HELP (4357)
Fax 330-733-4355

Click the map below to apply in that state:
Map of Ohio

GEORGIA
PO Box 465538
Lawrenceville, Georgia 30042
Phone: 678-407-8044
Fax: 678-559-0341

Click the map below to apply in that state:

Map of Georgia