MOR Coat/Toy Drive Collection(Need Application)

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Family Name *

Address *

Cell Number *

Home Number *

Family size *

Provision (Coat/Hats/Toy) Amount *

Statement of Need *

Can items be picked up? *

Yes

Would you like to be contacted by the organization periodically on your well being? *

Yes

Disclaimer: all applications must be processed and approved by the Directors of The MOR Foundation. Submission does not guarantee that your application will be accepted. You must meet the need criteria for approval. All applications must be received by December 15, 2013 12:00 Midnight. Applications received after the deadline will be automatically be placed on the wait list. You will receive notification from MOR foundation if your application has been approved. *

Type Name(acknowledging that you have read disclaimer)

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