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Charlotte's Hands of Hope
Fill out the form carefully and completely to apply for Back to School assistance for your students. We will accept as many families as resources allow. Families that have been approved will be notified by July 8, 2025 through email with a formal invitation to the "Back to School Family Picnic" Party on Sunday, July 20th from 5pm-7pm. At the event families will be able to enjoy family fun, a picnic and inflatables. Students will go home with a backpack, school supplies and a back to school outfit.
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?
*
Students Grade for 25/26 school year:
*
Type First 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?
*
Students Grade for 25/26 school year:
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?
*
Students Grade for 25/26 school year:
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?
*
Students Grade for 25/26 school year:
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?
*
Students Grade for 25/26 school year:
Type First 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?
*
Students Grade for 25/26 school year:
Type First 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 any other organization?
*
Please Select
Yes
No
Submit Application
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