De Quan Anderson Foundation Angel Tree Application Form
Parent/Guardian Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Children Information
Please Tell us a little about your situation
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of
I, undersigned, agree with the following statements:
I am the parent/guardian of the children listed above.
I acknowledge that I have read, understood and agreed to the guidelines for this program and authorize my child(ren) to receive christmas assistance through this program.
I understand that the program cannot guarantee that my children will receive items through this program.
I understand that if this organization is able to secure items for my children, they will contact me to let me know when and where items can be picked up. I also understand that I will need to complete a formal application at the time of pick up.
Date
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Month
-
Day
Year
Date
Signature
Submit
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