Goodfellows / Christmas for Kids Sign-Up Form

Head of Household*

First NameMiddle NameLast Name
Email*
example@example.com
Phone Number
Please enter a valid phone number.
Address*

Street Address

Street Address Line 2

CityState

Postal / Zip Code
Your Photo ID*

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Proof of Address *

Proof of address (a copy of a recent utility bill, rent receipt, recent mail with your name and address, or lease agreement)
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Proof of Income*

Proof of income for all Household members age 18 years or older (check stubs, Social Security, SSI, retirement pensions, Workman’s Comp, disability, child support, foster care support, unemployment benefits, or VA benefits).
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How many people, including yourself, live in your Household?*
Household includes everyone who lives in your house at least 6 months of the year.

Adults in Household

Excluding yourself, list everyone 18 or older who lives in your Household and include their Identification Information.
Adults
If none, leave blank. Separate names on new lines.
Adult IDs

You can select multiple files to upload.
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Children in Household

For each child 12 and under, please list their Name, Age, and Date of Birth.
Child 1

First NameLast Name
Child 1 Date of Birth

MonthDayYear
Child 1 Gender

MaleFemale
Child 1 ID

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Child 2

First NameLast Name
Child 2 Date of Birth

MonthDayYear
Child 2 Gender

MaleFemale
Child 2 ID

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Child 3

First NameLast Name
Child 3 Date of Birth

MonthDayYear
Child 3 Gender

MaleFemale
Child 3 ID

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Child 4

First NameLast Name
Child 4 Date of Birth

MonthDayYear
Child 4 Gender

MaleFemale
Child 4 ID

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Child 5

First NameLast Name
Child 5 Date of Birth

MonthDayYear
Child 5 Gender

MaleFemale
Child 5 ID

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Child 6

First NameLast Name
Child 6 Date of Birth

MonthDayYear
Child 6 Gender

MaleFemale
Child 6 ID

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Extra Children
Add additional children on new lines as displayed.
Extra Children ID

You can select multiple files to upload.
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Adults in Household