Christmas Angel Tree Family Assistance Application
Provide one application per household and list each child needing gifts, along with any required documentation.
Eligibility Verification
To help us make sure the Dirty Kautzman’s Diesel Angel Tree reaches local families who genuinely need assistance, we may use the information and documents below to verify eligibility. All verification information is private and will NOT be provided to donors or displayed on Angel tags.
IMPORTANT: Please cover, crop, or remove Social Security numbers, bank account and routing numbers, debit/credit card numbers, passwords, medical information that is not relevant to this application, and other unnecessary sensitive information before uploading documents. Dirty Kautzman’s Diesel Angel Tree does NOT need Social Security numbers or banking information to review your application.
Proof of Residency
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Child/Guardian Verification
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Additional Eligibility Documentation — Optional
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I understand that the documents I provide are being submitted for eligibility verification and that I should remove unnecessary sensitive information before uploading them.
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I understand
2026 Dirty Kautzman’s Diesel Angel Tree — Eligibility & Program Agreement
1. Children requesting assistance must be newborn through age 17 as of December 25, 2026. 2. This program is intended for local families in Marlow, Bray, Comanche, Velma, Duncan, Rush Springs, Stephens County, and surrounding communities experiencing financial hardship or circumstances that make providing Christmas gifts difficult. 3. The applicant must be the child’s parent, legal guardian, or person legally responsible for the child. Reasonable verification may be requested. 4. Only ONE application may be submitted per household. All children requesting assistance must be included on the same application. 5. All information provided must be truthful, complete, and accurate. 6. Applicants must disclose whether any child is receiving, approved for, or applying for Christmas assistance through another Angel Tree, Adopt-a-Family, church, school, nonprofit, or similar program. Applying elsewhere does not automatically result in denial; circumstances will be reviewed individually. However, prohibited duplicate Christmas assistance may affect eligibility. 7. Christmas needs and wishes are suggestions for donors. Specific gifts, brands, gift cards, dollar amounts, or requested items are NOT guaranteed. 8. Submitting an application does NOT guarantee acceptance. Applications are individually reviewed based on eligibility, circumstances, available resources, verification, and program capacity. 9. Private identifying information will NOT appear on public Angel tags or be provided to donors. Approved children will be assigned an Angel number. 10. Applicants must provide reliable contact information and respond to requests for additional information within the timeframe provided. 11. Approved families are responsible for following the designated gift pickup dates and instructions or contacting the program before the deadline if arrangements are needed. 12. Intentionally providing false information, falsified documentation, or intentionally concealing prohibited duplicate assistance may result in denial or removal from the program. 13. Applicants must NOT provide Social Security numbers, bank account numbers, credit/debit card numbers, passwords, or other unnecessary sensitive information.
Have you read, understood, and agreed to the 2026 Dirty Kautzman’s Diesel Angel Tree Eligibility & Program Agreement?
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Yes
No
Parent/Guardian Information
Parent/Guardian Full Legal Name
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First Name
Last Name
Primary Phone Number
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Please enter a valid phone number.
Format: (000) 000-0000.
Secondary Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
*
example@example.com
Physical Home Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Preferred Contact Method
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Call
Text
Email
Other
Best Time to Contact
Household Information
Number of adults living in the household
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Total number of children living in the household
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Are any children included in this application currently receiving, approved for, OR applying for Christmas assistance through another Angel Tree, Adopt-a-Family program, church, school, nonprofit organization, or similar Christmas assistance program?
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Yes
No
Child Information
Number of children requesting Angel Tree assistance
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Name of organization/program
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Which child or children are included
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Status
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Applied
Approved
Already Receiving Assistance
Brief explanation
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Please tell us a little about your family’s current circumstances and why Christmas assistance would be helpful this year.
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Child Information
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Final Certification
By signing below, I certify that the information provided in this application is true, complete, and accurate to the best of my knowledge. I understand that submitting an application does not guarantee acceptance into the 2026 Dirty Kautzman’s Diesel Angel Tree Program. I confirm that I have read and agreed to the program rules and understand that Dirty Kautzman’s Diesel Angel Tree may contact me if additional information or verification is needed.
Electronic Signature
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Date Signed
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-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
APPLICATION RECEIVED
APPLICATION RECEIVED
Should be Empty: