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2023 Miracle on 1st Street Turkey Registration Form
Distribution Event: November 20, 2023, 9am
Contact:
info@hollenbeckpbc.org
Note: Turkey are based on availability, 1st come 1st serve, sign up is not guarantee. MASKS are necessary and must be worn properly.
MUST BE PRESENT AT PICKUP. Bring ID upon pick-up. In person registration on Tuesday(7th) and (8th)
Location: 2015 E. 1st Street Los Angeles CA 90033
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First Name
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Last Name
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Email
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Phone
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Address
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City
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Zip code
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Affiliation or how did you hear about
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Hollenbeck Youth Center
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If Other- Who?
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Names and Ages (Members that live in your household: Relationship and Age) Example: Tom Jones, age 2, son
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Number of those living in household
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1
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7
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Will this service help you during the holiday season (serve as as a resource to relieve a financial burden)?
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No-- (follow up needed in order to proceed. Priority is given to those that this provides a resource)
Annual Gross Income
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How did you hear about this?
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I understand that this is need based and qualify. Availability is based on supply (1st come,1st serve).
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