'GIVING THANKS' Gift Card Application Form

Welcome to BLACK GIRL NEWS, LCC thanksgiving giveaway. We are providing free $100 grocery store gift cards to 20 Black women with children in need. Please carefully read this application. Make sure the information you provide is complete and accurate. Also, please do not leave any blank space. You will need to submit this form completely by November 15th, 2022 at 11:59pm. This giveaway is first come, first serve. Families will be selected by Community Service Chair. Thank you for your continuous support of the Black Girl News Platform.

Personal Information
Full Name *

First Name Middle Name Last Name
Gender *

Female
Birth Date *

Day Month Year
Are you a mother? *
Must be a mother with children.
E-mail *
Current Address (Please be aware the gift card will be shipped. Please verify your mailing address. We will not be resending any gift cards after postmarked. *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

Gift Card Selection
Please choose a gift card of your choice *

Kroger Publix Whole Foods

Attachments
In order to better evaluate you, we ask you to attach some documents. Please, notice that we ask you to send all the documents in good quality and in one of the following formats .PDF or .JPEG. The limit size per file is 500kb. Required documents: - Proof of identity (driver's license, state-issued ID, or passport). For children, proof of identity (state-issued ID, student ID, student report card, childcare receipts, driver's license, photo of you and child (children under 5 only), or passport). The document must visibly show your face and name. You only have to show proof of one child. Children's documents must show proof of relationship to the mother. Any other information can be blacked out.

NO BIRTH CERTIFICATES OR SOCIAL SECURITY CARDS
Proof of Identity (Mother) *
Driver's license, State-issued ID, or Passport
Proof of Identity (Child) *
Student ID, Driver's license, State-issued ID, Photo of you and child (for children under 5), or Passport
Student Report Card
Childcare Receipt
If you have any additional file, please attach it here
Documents for verification purposes only

Agreement to Terms and Conditions
Terms and Conditions

For the purposes of these Terms and Conditions, "The Promoter" refers to BLACK GIRL NEWS, LLC whose Instagram handle is @itsblackgirlnews. The "Prize" refers to one (1) $100 gift card. By entering the competition, you agree to be bound by these terms and conditions. The Promoter will not be held liable if the named prize becomes unavailable or cannot be fulfilled. Please verify your address for mail delivery. The Promoter will not be held liable for any failure of receipt of entries. The Promoter takes no responsibility for any entries which are lost, delayed, illegible, corrupted, damaged, incomplete or otherwise invalid. Prizes are non-negotiable, non-transferable and non-refundable. No cash alternative is available. The name, address, email address, phone number and proof of verification of the winner must be provided to The Promoter and will be shared to the community service chair in order to enable fulfilment of the Prize.

Privacy Policy

At BLACK GIRL NEWS, LLC (“Company”, “we”, “us” “our”), we respect our users (“User(s)” or “you(r)”) privacy. This Privacy Policy (“Privacy Policy”) summarizes what personal information we collect, and how we use and disclose this information. This Privacy Policy applies to all users of our services, which includes our products, content, website, giveaways and applications (collectively, the “Services”), and to people that create accounts with us through our website, apply for giveaways, upload content to our website, or purchase products from our website, or link their other online profiles to our website. By using our Services, or by entering our giveaway or linking an account on our website, you signify your consent to the terms of our Privacy Policy. If you do not agree with any terms of this Privacy Policy, please do not use our Services or submit any personal information to us.
The undersigned have read and understood the contract and agree to the terms and conditions in their entirety. *

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