in_wic (type: esriFieldTypeString, alias: If you are currently receiving services from WIC, please select Yes., SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
wic_id (type: esriFieldTypeString, alias: Please enter your WIC Card Number, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
in_head_start (type: esriFieldTypeString, alias: If you are currently receiving services from Head Start, please select Yes., SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
head_start_id (type: esriFieldTypeString, alias: Please enter your Head Start ID, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
in_snap (type: esriFieldTypeString, alias: If you are currently receiving services from SNAP, please select Yes., SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
snap_id (type: esriFieldTypeString, alias: Please enter your SNAP ID, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
in_tanf (type: esriFieldTypeString, alias: If you are currently receiving services from TANF, please select Yes., SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
tanf_id (type: esriFieldTypeString, alias: Please enter your TANF ID, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
in_medicaid (type: esriFieldTypeString, alias: If you are currently receiving services from Medicaid, please select Yes., SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
medicaid_id (type: esriFieldTypeString, alias: Please enter your Medicad ID, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
child_size (type: esriFieldTypeString, alias: Select the Diaper Size that you would like to receive, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [P: P], [4: 4], [N: N], ... 6 more ...)