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Charlotte's HANDS of HOPE
Fill out the form carefully and completely to apply for Christmas assistance for your family. We will accept as many families as resources allow. Families that have been approved will be notified by December 1, 2025 through email with a formal invitation to the "Christmas Night of Joy" Party on December 21st from 5pm-7pm. At the event families will be served a Christmas meal, provided with Christmas stockings, holiday activities and enjoy a visit & photos with Santa. That evening the families will be sent home with a box of gifts from the kids wish lists that parent's can give the kids on Christmas morning.
Head of Household
*
First Name
Middle Name
Last Name
Date of Birth
*
/
Month
/
Day
Year
MM-DD-YYYY
Gender
*
Male
Female
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email:
*
Confirmation Email
example@example.com
Phone Number
*
Please enter a valid phone number.
Number of people in your home:
Type number
Additional person(s) 18+ living in the home.
First Name:
First Name
Last Name
Date of Birth
/
Month
/
Day
Year
Date
Relationship to you:
Type spouse, partner, parent, child, or other
Second Name:
First Name
Last Name
Date of Birth
/
Month
/
Day
Year
Date
Relationship to you:
Type spouse, partner, parent, child, or other
Third Name:
First Name
Last Name
Date of Birth
/
Month
/
Day
Year
Date
Relationship to you:
Type spouse, partner, parent, child, or other
Children under the age of 18 in the home
First child:
*
First Name
Last Name
Date of Birth
*
/
Month
/
Day
Year
Date
Age:
*
Boy or Girl?
*
What school does the child attend?
*
Wish #1:
*
Type First Wish
Wish #2:
*
Type Second Wish
Wish #3:
Type Third Wish
Clothing Size (please indicate if it is children's size or adult size):
*
Shirt & Pant Size
Shoe Size (please indicate if it is children's size or adult size):
*
2nd Child:
First Name
Last Name
Date of Birth
/
Month
/
Day
Year
Date
Age:
Boy or Girl?
What school does the child attend?
*
Wish #1:
Wish #2:
Wish #3:
Clothing Size (please indicate if it is children's size or adult size):
Shirt & Pant Size
Shoe Size (please indicate if it is children's size or adult size):
3rd Child:
First Name
Last Name
Date of Birth
/
Month
/
Day
Year
Date
Age:
Boy or Girl?
What school does the child attend?
*
Wish #1:
Wish #2:
Wish #3:
Clothing Size (please indicate if it is children's size or adult size):
Shoe Size (please indicate if it is children's size or adult size):
4th Child: Name
First Name
Last Name
Date of Birth
/
Month
/
Day
Year
Date
Age:
Boy or Girl?
What school does the child attend?
*
Wish #1:
Wish #2:
Wish #3:
Clothing Size (please indicate if it is children's size or adult size):
Shirt & Pant Size
Shoe Size (please indicate if it is children's size or adult size):
5th Child: Name
First Name
Last Name
Date of Birth
/
Month
/
Day
Year
Date
Age:
Boy or Girl?
What school does the child attend?
*
Wish #1:
Type First Wish
Wish #2:
Type Second Wish
Wish #3:
Type Third Wish
Clothing Size (please indicate if it is children's size or adult size):
Shirt & Pant Size
Shoe Size (please indicate if it is children's size or adult size):
6th Child: Name
First Name
Last Name
Date of Birth
/
Month
/
Day
Year
Date
Age:
Boy or Girl?
What school does the child attend?
*
Wish #1:
Type First Wish
Wish #2:
Type Second Wish
Wish #3:
Type Third Wish
Clothing Size (please indicate if it is children's size or adult size):
Shirt & Pant Size
Shoe Size (please indicate if it is children's size or adult size):
How did you hear about Charlotte's Hands of Hope?
How did you hear about Charlotte's Hands of Hope & Christmas Night of Joy?
*
Social Media
Website
School Counselor or School
Church
Friend
Other
If you were referred by a school, school counselor or church please list it below. If not put N/A
*
Monthly Income:
Income for Household
*
First Name
Last Name
Amount received in Salary Monthly:
*
Type Amount
Are you going to request assistance from anywhere else?
*
Please Select
Yes
No
Submit Application
Clear Fields
Should be Empty: