2025 BCCF Christmas Assistance Application- South Bryan

Bryan County Family Connection- Bryan County Children's Fund Christmas Angel Program - Holiday Supplement Application

2025 - South Bryan County - Please complete the entire application fully- Reach out to our office at 912.653.3824 if you have any questions or concerns
Name of Parent/Legal Guardian*
Date of Birth*

MonthDayYear
Date
List Any Other Adults in Home:*
Physical Address*
Telephone/Contact Number*
Additional Contact Number*
Email Address*
example@example.com
Have You Received BCCF Assistance In The Last 3 Years? *
Are You or Anyone In Your Home Active Duty or Retired Military?*
Place of Employment and Monthly Income *
Place of Employment and Monthly Income *
Additional Household Income*

NoneSNAP Benefits (Food Stamps)Child SupportSSIDisabilityUnemploymentOther
Total Monthly Household Income, Including All Sources of Income*

Please complete the information below, for each child, ages 1-15, that currently lives in your home. Please be very specific with each child's hobbies and interests. Please be specific with sizes (infant, toddler, child, junior, misses, women, men, etc...) Include bra sizes, if appropriate. *

	Child’s Name	Date of Birth	SS	Age	Sex	Ethnicity	Shirt Jacket Size	Pants Size	Shoe Size	Wish List
1
2
3
4
5
6
7
8
9

I certify that all information is correct. I acknowledge that any false information provided on this application or any attempt to return gifts for cash at any retail store will make my family permanently ineligible for assistance. My signature below authorizes the release of the above information to Bryan County Children's Fund, its affiliates, and agencies.
Signature of Parent/Legal Guardian*

Clear
Date*

MonthDayYear
Date
Should be Empty:

Bryan County Family Connection- Bryan County Children's Fund Christmas Angel Program - Holiday Supplement Application