WorkReleaseFormHHWPlanSummaryNotice of Non-DiscriminationFollow-UpIdentityAffidavit forChildrenUnder 16IncomeTaxHouseholdSizeHIPPlanSummaryConflict ofInterestFormMartialStatusFaxFormARFEligibilityIndividualSolutionsPowerAcctFormCHARITYGUIDECERNERFREE!ScreeningDeterminationof DisabilityRMI FormWorkReleaseFormHHWPlanSummaryNotice of Non-DiscriminationFollow-UpIdentityAffidavit forChildrenUnder 16IncomeTaxHouseholdSizeHIPPlanSummaryConflict ofInterestFormMartialStatusFaxFormARFEligibilityIndividualSolutionsPowerAcctFormCHARITYGUIDECERNERFREE!ScreeningDeterminationof DisabilityRMI Form

BINGO ELIGIBILITY - Call List

(Print) Use this randomly generated list as your call list when playing the game. There is no need to say the BINGO column name. Place some kind of mark (like an X, a checkmark, a dot, tally mark, etc) on each cell as you announce it, to keep track. You can also cut out each item, place them in a bag and pull words from the bag.


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  1. Work Release Form
  2. HHW Plan Summary
  3. Notice of Non-Discrimination
  4. Follow-Up
  5. Identity Affidavit for Children Under 16
  6. Income
  7. Tax Household Size
  8. HIP Plan Summary
  9. Conflict of Interest Form
  10. Martial Status
  11. Fax Form
  12. ARF
  13. Eligibility
  14. Individual Solutions
  15. Power Acct Form
  16. CHARITY GUIDE
  17. CERNER
  18. FREE!
  19. Screening
  20. Determination of Disability RMI Form