OFFICIAL 2025 "HORN OF PLENTY" FAMILY REGISTRATION FORM

OFFICIAL 2025 "HORN OF PLENTY" FAMILY REGISTRATION FORM

(Applications must be received by 5:00 p.m. Wednesday, 12/3/2025. Families cannot submit their own names for the Horn of Plenty Program.)
PROFILE OF FAMILY :
Is this a single parent family?*
Mothers Age
Fathers Age
NUMBER OF IMMEDIATE FAMILY LIVING IN HOUSEHOLD*
HEAD OF HOUSEHOLD NAMES (Must Include all Parents First and Last Names or Submission will be disqualified.) *
Enter all names in this box
HOME PHONE
CONTACT INFORMATION FOR FAMILY DELIVERY :

Must have correct information in order for the family to receive a Horn of Plenty Gift!
HOME PHONE
CELL PHONE OR TEXTING NUMBER
EMAIL
example@example.com
Address*

ADDRESS

Street Address Line 2

CITYState / Province

ZIP
(NO P.O. Box #'s please! We use this address to locate the families for Deliveries, and cannot deliver to a P.O. Box)
PROFILE OF CHILDREN :
Ages and Gender are needed for toys. Child must live in household 75% of the time to be considered immediate family. (Please list Immediate Family Only-Extended Family or Relatives need to be submitted separately as their own family unit)
Child 1 Information
Child 2 Information
Child 3 Information
Child 4 Information
Child 5 Information
Child 6 Information
Child 7 Information
Child 8 Information
Child 9 Information
Child 10 Information
IS THERE A NEED FOR TOYS?*

YESNO
WRITE A SYNOPSIS OF NEED AND FAMILY CONDITION (This information is needed for the family to be considered.)*
On a scale of 1 to 5 how would you rate this family's need? With 1 being : This family would have a nice Christmas with some extra help. To 5 being the worst case senario: This family does not know how they are going to feed themselves in the next few days.
On a scale of 1 to 5 rate this family need level.*

1

2

3

4

5

1 is Little Need, 5 is Severe Need
NAME OF PERSON SUBMITTING FORM :

(Must be completed in full. If not, this form will be discarded. No family can submit themselves.)
SUBMITTING FAMILY NAME*
SUBMITTING FAMILY CELL PHONE *
SUBMITTING FAMILY ADDRESS*
SUBMITTING FAMILY CITY*
SUBMITTING FAMILY STATE*
SUBMITTING FAMILY ZIP*
(All information will be held in strict confidence) Please do not contact the families, as we do not want them to know their names have been submitted. Any family that contacts the program to ask when their package is going to be delivered will be removed from the program. The Horn of Plenty program is here to extend help to families in need during the 2025 Christmas Season. Submitting this form is not a guarantee that the family will receive a package from the Horn of Plenty Program. Past needs have exceeded our ability to reach every name submitted, thus we cannot guarantee delivery to every name submitted.

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OFFICIAL 2025 "HORN OF PLENTY" FAMILY REGISTRATION FORM

CONTACT INFORMATION FOR FAMILY DELIVERY :

PROFILE OF CHILDREN :