Sandusky County Community Christmas Assistance Application 2021
***Although Community Christmas would like to grant all requests for assistance, the need in our community is
great, and therefore, we cannot guarantee that every request will be fulfilled. Families will be notified if they have been matched with a donor. You will receive your notification by December 6, 2021, along with instructions on how your gifts will be made available to you. ***

Eligibility Requirements
o Applicants must be a resident of SANDUSKY COUNTY
o Applicants must provide the last four digits of SOCIAL SECURITY NUMBERS for ALL listed household members
o Applicants must provide at least ONE WORKING TELEPHONE NUMBER
o Application must be electronically SIGNED BY THE HOUSEHOLD CONTACT PERSON
o Only ONE APPLICATION PER ADDRESS is allowed – if two families reside at one address they must be listed on the same application

In 2021 applications will ONLY be accepted via electronic submission. The online form will only be made available until Monday, November 30th at 4:00PM. After that time the form will no longer receive applications.

All required fields MUST be completed in order to submit the form. Incomplete forms will not be accepted. Please email communitychristmas.sc@gmail.com if you have any questions related to submission of your electronic application.
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I confirm that I am a resident of Sandusky County and at least one member of my household is either a child under age 12 or a senior over age 65. *
Required
Full Name of Primary Household Contact *
If the primary contact is eligible for gifts as a senior over age 65 please be sure to complete the section for a senior in addition to the information in this section.
Street Number of Address *
Only one application per address will be accepted. If multiple households are sharing an address they must all be included within this application submission.
Name of Street *
Apartment/Lot Number (if necessary)
Zip Code *
Primary Phone Number (with area code using only the numbers no spaces or -) *
Should your phone number change prior to December 24, 2020 you must update us with your new number by calling or emailing us.
Can we text your primary phone number with updates regarding Community Christmas? *
Secondary Phone Number (with area code using only the numbers no spaces or -)
Will be utilized in case the primary number becomes unreachable. Please utilize a secondary number that will remain connected throughout the length of Community Christmas.
Can we text your secondary phone number with updates regarding Community Christmas?
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Email address
If provided you will receive the most updates regarding Community Christmas.
Gender *
Last 4 digits of Social Security Number *
Birthdate *
MM
/
DD
/
YYYY
I am completing this form for assistance for the following: *
If you are completing for both a child under age 12 and a senior over age 65 in the same household, begin with any children and the form will then offer you to complete for any seniors.
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