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Holiday Assistance Application
Currently accepting applications for the following counties: Spotsylvania, Stafford, Fredericksburg City. Our organization is committed to assisting families in need during the holiday season. Please complete the following application in full so we may review your request and determine eligibility for holiday assistance.
Name:
*
First Name
Middle Name
Last Name
Birth Date
*
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Day
Please select a year
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Year
Phone Number:
*
E-mail Address:
*
example@example.com
Address:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Monthly Household Income:
*
Upload Driver's License:
*
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Upload last 2 paystubs/proof of income:
*
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Child 1
Please provide the below information for each child in the household.
Name
Age
Gender
Please Select
Male
Female
Prefer not to say
Clothing Size
Wishlist:
*
Child 2
Please provide the below information for each child in the household.
Name
Age
Gender
Please Select
Male
Female
Prefer not to say
Clothing Size
Wishlist:
Child 3
Please provide the below information for each child in the household.
Name
Age
Gender
Please Select
Male
Female
Prefer not to say
Clothing Size
Wishlist:
Child 4
Please provide the below information for each child in the household.
Name
Age
Gender
Please Select
Male
Female
Prefer not to say
Clothing Size
Wishlist:
Child 5
Please provide the below information for each child in the household.
Name
Age
Gender
Please Select
Male
Female
Prefer not to say
Clothing Size
Wishlist:
Child 6
Please provide the below information for each child in the household.
Name
Age
Gender
Please Select
Male
Female
Prefer not to say
Clothing Size
Wishlist:
Pick up or Delivery?
We will provide a shopping experience on December 4th and 5th, where parents can select gifts for their children. For those unable to attend in person, a personal shopper with delivery will be available. Time Slots will be selecting after your application is approved.
Which option would you like?
Please Select
Delivery
Shopping Experience
Would you need childcare while you shop?
If you choose the shopping experience, on-site activities will be available for children in a separate area while you shop. Would you be interested in this option?
Do you plan to have your child(ren) attend our Winter Wonderland(childcare)?
Please Select
Yes
No
N/A-I need delivery
Have you accepted holiday assistance from any other organizations?
Please Select
Yes
No
By signing below, you understand that submission of your application does not guarantee acceptance to the program.
Signature
Submit Application
Submit Application
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