beYOUtiful Inc. Christmas Wish Holiday Program 🎄

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Parent/Guardian’s Name* This field is required.To ensure that all approved applicants are served, a government issued ID is required.

First Name

Last Name

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Applicants Phone Number* This field is required.

Area Code

Phone Number

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Applicants E-mail Address* This field is required.

4

Applicants Address* This field is required.

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

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Preferred Contact Method

Phone

Email

Text

Other

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Child(ren) Info* This field is required.

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Are you the Mother, Father or Legal Guardian to the child/children listed?** This field is required.

Yes

No, please give a explanation in the comments section.

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Do you receive any form of government assistance (TANF, SNAP, Medicaid, etc.)?

YESNO

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Have you received Toys for Tots assistance from us in the past?

YESNO

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Have you registered with any other Toys for Tots or holiday assistance program this year?

YESNO

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Would you like to make an optional donation? “Remember, it’s better to give than to receive. No gift is too small when it comes from the heart.”

YESNO

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If yes, please choose your preferred donation method: (MultipleNote: Donations are completely optional and do not influence eligibility or selection.

PayPal: beyoutiful_01@yahoo.com

Apple Pay

In-Person

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Children's Santa Wish List Please Provide a Detailed Item List for each of the children listed above of some items they have on there list for Santa.

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We Can't Forget about you Mom/Dad/GuardianPlease provide something you would like for Christmas!!!! Favorite Color(s): Clothing Sizes (shirt, pants, dress, shoes): Gift Ideas / Interests (optional: toiletries, accessories, cozy items, self-care)

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*Please Read Carefully

beYOUtiful Inc. is proud to serve as a donation site for Toys for Tots. Each application is submitted as a request and therefore not guaranteed. All application decisions are granted at the sole discretion of Toys for Tots and its partners. Please submit all required documents before the specified date so that your request will be processed in an efficient timeframe. Please fill out all required information so we can keep you updated on your application status. To ensure that all approved applicants are served, a government issued ID is required.

If you have any questions please leave it in the box below.

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Comments or Questions:

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Electronic Disclosure and Signature Agreement

I know that any information given to beYOUtiful Inc. will be protected and kept confidential.

I know that the information on this application is needed to determine eligibility for beYOUtiful Inc. and/or my information will be checked against electronic databases at either the NC Dept. of Health and Human Services, or the US Marines Toys for Tots centers.

By entering your name on the signature line, you are signing this Application electronically. You agree that your electronic signature is the legal equivalent of your manual signature on this Application and is as valid as if you signed the document in writing. You also agree that no certification authority or other third party verification is necessary to validate your E-Signature, and that the lack of such certification or third party verification will not in any way affect the enforceability of your E-Signature. You further agree that your electronic signature grants beYOUtiful Inc. the permission to confirm, where applicable, your income eligibility criteria, and or my child’s enrollment at Wake County Public Schools , and or the residential information entered on this application.

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I certify that all information provided is true and accurate to the best of my knowledge.”

I Agree

I Don’t Agree

Other

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Electronic Signature* This field is required.

First and Last Name

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DateTime

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Upload Required DocumentsRequired Documents: Please upload the following (as applicable): Valid photo ID Proof of income or assistance (pay stub, benefits letter, etc.) Proof of children’s age (birth certificate, Medicaid card, or school record)

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