2018 Christmas Toy Assistance Application
Assistance available for residents in the Gahanna Jefferson School District, only.
Email address *
First Name *
Your answer
Last Name *
Your answer
Street Address *
Your answer
City and Zipcode *
Your answer
Email Address
Your answer
Primary Phone Number *
Your answer
Secondary Phone Number
Your answer
TOTAL NUMBER IN HOUSEHOLD *
Your answer
HOUSEHOLD INFORMATION -- other adults
Please list all other adults (post high school) living in the household besides yourself.
Adult #1 (first and last name)
Your answer
Adult #2 (first and last name)
Your answer
Adult #3 (first and last name)
Your answer
Adult #4 (first and last name)
Your answer
Are you sharing your home with another family? *
If yes, list family last name
Your answer
HOUSEHOLD INFORMATION -- Children (infant-high school)
Please list all children. Must be infant through high school or special needs adult. Children must live in your household.
Child #1 (first and last name)
Your answer
Gender
Age
Your answer
Grade and School
Your answer
Child #2 (first and last name)
Your answer
Gender
Age
Your answer
Grade and School
Your answer
Child #3 (first and last name)
Your answer
Gender
Age
Your answer
Grade and School
Your answer
Child #4 (first and last name)
Your answer
Gender
Age
Your answer
Grade and School
Your answer
Child #5 (first and last name)
Your answer
Gender
Age
Your answer
Grade and School
Your answer
Child #6 (first and last name)
Your answer
Gender
Age
Your answer
Grade and School
Your answer
ASSISTANCE REQUESTED
Christmas Meal, Christmas Gifts
Christmas Meal -- Attend any food pantry in December for Christmas meal provisions. Call 614-214-4747 to schedule an appointment *
Christmas Gifts --Only for children infant through high school or special needs adults. 12/15/18 at Gahanna Middle School South 10am -1pm *
Secondary Contact Information
In the event GRIN is unable to contact you, please provide additional contact information.
First and Last Name *
Your answer
Phone Number *
Your answer
Relationship *
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