Clone of 2025 GOG Christmas Assistance Application

Graces of Gurley Christmas Assistance Application 2026:

Please complete this application truthfully and thoroughly. Please note that this application must be completed by the primary parent or legal guardian who directly cares for the child. It cannot be filled out on behalf of extended family members. As part of our application process, you’ll be asked to schedule a face-to-face meeting to help us prepare for your family's participation in our upcoming Christmas Market. This meeting is an important step and is required to receive services. We understand that schedules can change—if you're unable to attend your selected time, please give us a call at 469-556-9083, and we’ll be happy to help you reschedule. Please keep in mind that missing this meeting without rescheduling may result in your application being canceled. Grace's (GoG) reserves the right to deny applications known to contain false information, based on GoG's knowledge of the families we serve. At the discretion of GoG, applicants may or may not be permitted to correct falsified information.
Parent/Guardian Name:

First NameLast Name
Spouse/significant other living in same household

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Format: (000) 000-0000.
E-mail
example@example.com
First Child's Name

FIrst & Last NameGradeDate of Birth
Second Child's Name

FIrst & Last NameGradeDate of Birth
Third Child's Name

FIrst & Last NameGradeDate of Birth
Fourth Child's Name

First & Last NameGradeDate of Birth
Fifth Child's Name

FIrst & Last NameGradeDate of Birth

MONTHLY HOUSEHOLD EXPENSES

Rows	Payment Amount
Rent
Utilities/Propane
Phone
Medical
Car payment(s)
Insurance
Loans
Spousal Support
Child Care
Furniture
Food/Necessities
Credit Card(s)
Cable/Internet
Other

Total Household Expenses Calculation:
Do you receive government assistance for food?
If not, please explain above
Landlord's name and phone number (if applicable):

INCOME SOURCES (you must list everyone living with you). Put the number 0 in column one if the category does not apply. Put N/A in column two if the category does not apply:

Rows	Parent/Guardian	Spouse/Other Adults 18 & over
Place of Employment
Weekly/Monthly Salary
Food Assistance/SNAP
Child Support
WIC
SSI/Disability
Spousal Support
Other

Total Income Calculation
Total number of people residing in household:
For elderly/disabled, are you eligible for SSA/SSI/SSD? If so, do you receive it?
If not, please explain above
If you are unemployed, are you receiving unemployment?
If not, please explain above
By signing below, I certify that all information provided in this application is accurate and complete to the best of my knowledge.

Accuracy of Information: I understand that providing false information or intentionally withholding details may result in a denial or discontinuation of services by Graces of Gurley.

Keeping Us Updated: I agree that it is my responsibility to notify Graces of Gurley if any of my household or contact information changes.

Community Care Collaboration: To ensure we can serve you as effectively as possible, I understand that this information may be shared confidently with trusted community partners.
First Name Last Name Date
Signature
In order to receive Christmas assistance, you are required to participate in a one-on-one interview with a Graces of Gurley representative. Please use the calendar below to schedule your interview time.

If you are unable to make your scheduled time, call 469.556.9083 to reschedule. Also, if one of these available time slots will not work for you, call or text to set up a specific time. Please note: The interview is REQUIRED for you to receive assistance.
Appointment for Christmas Assistance located at the Graces of Gurley building
Should be Empty:

Graces of Gurley Christmas Assistance Application 2026:

In order to receive Christmas assistance, you are required to participate in a one-on-one interview with a Graces of Gurley representative. Please use the calendar below to schedule your interview time.