Nelsonville/ York Christmas Basket Application 2021
*NOTICE PLEASE READ*

Anyone submitting a completed application IS NOT guaranteed to receive a Christmas Basket. All applicants MUST BE RESIDENTS OF NELSONVILLE OR YORK TOWNSHIP. All applications must be submitted by Friday, December 10, 2021. All approved Christmas Baskets will be delivered on Saturday, December 18, 2021 between the hours of 8:00 a.m. and 2:00 p.m.

YOU MUST BE HOME TO RECEIVE A CHRISTMAS BASKET!!!
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Email *
First Name *
First name
Last Name *
Last name
Email *
Telephone number where family can be reached *
House Number (Address) *
Street/ Road Name *
Directions, house or trailer color, etc: *
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