Single Parent Christmas Grant Application
We are pleased to offer the Single Parent Christmas Grant to support single parents during the holiday season. This grant is intended to provide financial assistance for families who may be facing challenges and need help making this Christmas season joyful and memorable. There will be multiple winners of this Grant. Please note that there will be a $20 application fee.
Application Information
1. Personal Information
Name
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Number of Children
*
Ages of Children
*
2. Financial Information
Employment Status
*
Employed Full-time
Employed Part-time
Unemployed
Student
Other (please specify):
Monthly Household Income
*
Less than $1,000
$1,001 - $2,000
$2,001 - $3,000
More than $3,000
Do you receive any additional financial support (child support, government assistance, etc.)?
*
Yes
No
3. Holiday Needs and Plans
How much are you requesting for the Christmas Grant
*
$100
$200
$300
$500
Other
What do you plan to use the grant for?
*
Gifts for children
Christmas Dinner
Holiday decorations
Utilities or household expenses
Other
4. Personal Statement
Please provide a brief statement explaining why you are applying for the Christmas Grant and how it will help you and your family this holiday season.
*
0/300
5. Additional Documentation (Optional)
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You may provide any supporting documentation that demonstrates financial need (e.g. rent pay stub, rent, or utility bills, etc.).
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6. Consent and Signature
I here by declare that the information provided in this application is true and complete to the best of my knowledge. I understand that any false information may disqualify me from receiving the grant.
*
Important Information
ONLY single parents (custodial) with financial need are eligible to apply.
Selected recipients will be notified via phone or email.
Funds will be distributed by Christmas.
An application submission DOES NOT guarantee that you will win.
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Application Fee
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