First Name: Last Name:
     
Relationship to Child(ren): Email:
     
Street Address: City:
     
State:   Zip:
     
Two telephone numbers to reach you:
 
Total Number of Adults (18+)   Total Number of Children (0-17)
     
Your Income (please check all that apply)    
General Assistance Disability Job  
SNAP/Food Stamps SSI TANF Unemployment Benefit
Other   Total Monthly Income:
       
Is this your first time applying for Christmas toys at The Salvation Army? Yes ... No  
       
Please explain why you are in need of help from The Salvation Army this year:
 
Please Complete One Wish List For Each Child
The gift suggestions are to help us understand your child's interests. These items are NOT guaranteed!
 
Child's first name only
Gender
Age
Three Gift Suggestions Less Than $100 Each
Clothing Size
Shoe Size


Boy

Girl









  years
months
 
toddler
youth
adult

 
toddler
youth
adult

 
Child's first name only
Gender
Age
Three Gift Suggestions Less Than $100 Each
Clothing Size
Shoe Size


Boy

Girl









  years
months
 
toddler
youth
adult

 
toddler
youth
adult

 
Child's first name only
Gender
Age
Three Gift Suggestions Less Than $100 Each
Clothing Size
Shoe Size


Boy

Girl









  years
months
 
toddler
youth
adult

 
toddler
youth
adult

 
Child's first name only
Gender
Age
Three Gift Suggestions Less Than $100 Each
Clothing Size
Shoe Size


Boy

Girl









  years
months
 
toddler
youth
adult

 
toddler
youth
adult

 
Child's first name only
Gender
Age
Three Gift Suggestions Less Than $100 Each
Clothing Size
Shoe Size


Boy

Girl









  years
months
 
toddler
youth
adult

 
toddler
youth
adult

               
     
I would like more information about The Salvation Army
       
PLEASE REVIEW YOUR APPLICATION BEFORE HITTING THE SUBMIT BUTTON
By submitting this application you agree to the following:
1. You acknowledge that the information you have provided is accurate.
2. You give The Salvation Army permission to contact you using the email address(es) and phone numbers you listed on this application.
3. You understand that The Salvation Army will provide toys for the children in your home ages birth to 12. We will do our best to provide gifts for children from 13 to 17 but we do not guarantee teen gifts.
4. You agree to pick up toys at your given appointment day and time.
5. You give permission for The Salvation Army to clear your name through a central list in order to avoid duplication of services.
PLEASE NOTE: Once submitted you will receive a confirmation email at the address you provided.
If this is not received we DID NOT receive your application.