2024 Thanksgiving Food Basket Application

2024 Thanksgiving Food Basket Application

You must register and bring your ID to pick up the food basket. Pick up date is Nov. 23rd from 10am-12 noon and the location is Hills Chapel CME Church, 1113 I Ave., Plano, TX 75074. You will be sent an email of confirmation by the 15th.
Name of Applicant*

PrefixFirst NameMiddle NameLast Name
Applicants Birthdate*

MonthDayYear
Applicants Phone Number*

Area CodePhone Number
Applicants E-mail Address
Applicants Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Child(ren) Info*
Electronic Signature*
First and Last Name
Electronic Disclosure and Signature Agreement
- I know that any information given to Douglass Visions Committee, Inc. will be protected and kept confidential.
- By entering your name on the signature line, you are signing this Application electronically. You agree that your electronic signature is the legal equivalent of your manual signature on this Application and is as valid as if you signed the document in writing. You also agree that no certification authority or other third party verification is necessary to validate your E-Signature, and that the lack of such certification or third party verification will not in any way affect the enforceability of your E-Signature. You further agree that your electronic signature grants Douglass Visions Committee, Inc. the permission to confirm, where applicable, your income eligibility criteria, and or the residential information entered on this application.
- You understand that this application does not guarantee you will receive a food basket. You will be placed on a list and emailed a date and time to pick it up after you have been guaranteed you will get a basket. Baskets will not be held over for any reason.
- For questions email: douglassvisionsinfo@gmail.com.
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