• Maine Children's Home Christmas & Winter Essentials Program Application

    For Ages Birth - 12
  • Please read the following instructions and information carefully before proceeding.

  • Maine Children’s Home (MCH) understands that when you’re financially insecure, the holidays are stressful. We are here to try to help!

    This program is intended for Maine families who need help to provide holiday gifts and winter essentials to their children between the ages of 0–12 years. It is intended only for those who have no other way of providing gifts for their children and provides a basic care package that could include clothing, winter gear, toys, gifts, and books. We do not provide gaming systems, video games, tablets, cell phones, computers, gift cards, event tickets, or high value items.

    Terms of this agreement between You and Maine Children's Home:

    Only parents or legal guardians should complete this application. If you are a caseworker or representative of a parent or legal guardian assisting a client, please make sure that the client is present so that they are able to provide complete and accurate information. Please communicate clearly with your client regarding pick up instructions in order to avoid confusion and unnecessary stress.

    • You must live in Maine to participate.
    • You must meet our income guidelines (shown at the bottom of this page).
    • If you are applying for our program, it should be your only source of holiday help for your children.  Attempting to obtain gifts from other sources such as your child's school, your town office, or the Salvation Army, or providing false information on this application, is considered theft by deception (and is punishable by law). We do enforce these requirements, and we check with schools, caseworkers, and other programs to ensure that applicants are not receiving help from multiple sources. We want to make sure that this support is available for people who genuinely need this help.
    • Care packages are distributed at Maine Children’s Home at 93 Silver Street in Waterville. Please make sure you are able to pick up your care package in Waterville or can arrange a ride to pick it up, before you apply. 
    • Once you’ve submitted your application, you will receive an email confirmation from no-reply@jotform.com email address. Make sure to check your junk email box if you don't see it within an hour. Keep the confirmation number that is noted in your email. A member from our team will contact you to provide pick-up instructions. You will need to tell them the confirmation number, or you will not receive your care package.

     

    PLEASE NOTE, AS THIS HAS CHANGED 

    Care packages will be distributed this year between November 30 – December 19. Further instructions for pick-up will be provided when we contact you.

    MCH offices are closed on the following dates:

    • Monday, October 12
    • Wednesday, November 11
    • Wednesday, November 25- Closing at 12 PM
    • Thursday, November 26
    • Friday, November 27
    • Thursday, December 24 – Friday, January 1

    If you need to contact us before we provde pick-up instructions, you can email us at essentials@mainechildrenshome.org or by phone 207-873-4253 and choose option 1 when prompted. Please note that when we contact you to provide pick-up instructions, it may not be from this specific phone number.

    Below, you will be asked a series of questions to determine if you qualify for the Christmas & Winter Essentials Program. Please answer all questions truthfully.

    Your application will not be processed if it is incomplete. 

    Before you continue with this application, have all this important information ready:

    • A current Maine address
    • Clothing sizes, shoe sizes, and interests of each child you are applying for
    • A valid email address where your confirmation will be sent
    • A working phone number that is set up to receive calls, voicemail, or text messages (We cannot make arrangements with you to pick-up your care package if we can’t reach you)
    • Total household monthly income from all members of the household and all sources (Wages, SSI, TANF, Child Support, etc.) Please see our income eligibilty guidelines below.

    Income Eligibility

    Household Size Monthly Income Limit
    2 $2,398
    3 $3,027
    4 $3,657
    5 $4,287
    6 $4,916
    7 $5,546
    8 $6,175
    9 $6,805
    10 $7,434

     

     

     

     

     

     

     

     

     

    Add $630 per person if over 10 members in your household

     

  • Do you agree to our terms of agreement as noted above?*
  • Parent/Guardian Contact Information

  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • What is your preferred method of communication?*
  • When is the best time of day to call you?
  • Additional Resources

    Included with your request for a care package, your family will also receive a Well-being Toolkit. The Well-being Tool-kit promotes positive mental and physical health through various activities.
  • Are you aware of resources available to in your community that help children and families? (Besides MCH Christmas & Winter Essentials)
  • Would you like a case manager from MCH to contact you to help you discover other community supports? (MCH may not be able to help with all needs, but may be able to point you in the right direction)
  • How would you like our case manager to contact you?
  • Applicant Family Information

  • Child Information

  • Child 1 Information

  • Child 1 Essential Needs

    Please select from the following essentials. We cannot guarantee that all items requested will be available, however we will do our best.
  • Please select essential items you would like for Child 1
  • Child 1 Interests

    Please tell us about your child's interests, this will help our volunteers when selecting gifts for your child. Please note that we cannot guarantee specific items, but we try our best to find similar items.  We do not provide gaming systems & accessories, video games, cell phones, computers/tablets, event tickets, and gift cards.
  • Please select Child 1's top five interests
  • Child 2 Information

  • Child 2 Essential Needs

    Please select from the following essentials. We cannot guarantee that all items requested will be available, however we will do our best.
  • Please select essential items you would like for Child 2
  • Child 2 Interests

    Please tell us about your child's interests, this will help our volunteers when selecting gifts for your child. Please note that we cannot guarantee specific items, but we try our best to find similar items.  We do not provide gaming systems & accessories, video games, cell phones, computers/tablets, event tickets, and gift cards.
  • Please select Child 2's top five interests
  • Child 3 Information

  • Child 3 Essential Needs

    Please select from the following essentials. We cannot guarantee that all items requested will be available, however we will do our best.
  • Please select essential items you would like for Child 3
  • Child 3 Interests

    Please tell us about your child's interests, this will help our volunteers when selecting gifts for your child. Please note that we cannot guarantee specific items, but we try our best to find similar items.  We do not provide gaming systems & accessories, video games, cell phones, computers/tablets, event tickets, and gift cards.
  • Please select Child 3's top five interests
  • Child 4 Information

  • Child 4 Essential Needs

    Please select from the following essentials. We cannot guarantee that all items requested will be available, however we will do our best.
  • Please select essential items you would like for Child 4
  • Child 4 Interests

    Please tell us about your child's interests, this will help our volunteers when selecting gifts for your child. Please note that we cannot guarantee specific items, but we try our best to find similar items.  We do not provide gaming systems & accessories, video games, cell phones, computers/tablets, event tickets, and gift cards.
  • Please select Child 4's top five interests
  • Child 5 Information

  • Child 5 Essential Needs

    Please select from the following essentials. We cannot guarantee that all items requested will be available, however we will do our best.
  • Please select essential items you would like for Child 5
  • Child 5 Interests

    Please tell us about your child's interests, this will help our volunteers when selecting gifts for your child. Please note that we cannot guarantee specific items, but we try our best to find similar items.  We do not provide gaming systems & accessories, video games, cell phones, computers/tablets, event tickets, and gift cards.
  • Please select Child 5's top five interests
  • Child 6 Information

  • Child 6 Essential Needs

    Please select from the following essentials. We cannot guarantee that all items requested will be available, however we will do our best.
  • Please select essential items you would like for Child 6
  • Child 6 Interests

    Please tell us about your child's interests, this will help our volunteers when selecting gifts for your child. Please note that we cannot guarantee specific items, but we try our best to find similar items.  We do not provide gaming systems & accessories, video games, cell phones, computers/tablets, event tickets, and gift cards.
  • Please select Child 6's top five interests
  • Child 7 Information

  • Child 7 Essential Needs

    Please select from the following essentials. We cannot guarantee that all items requested will be available, however we will do our best.
  • Please select essential items you would like for Child 7
  • Child 7 Interests

    Please tell us about your child's interests, this will help our volunteers when selecting gifts for your child. Please note that we cannot guarantee specific items, but we try our best to find similar items.  We do not provide gaming systems & accessories, video games, cell phones, computers/tablets, event tickets, and gift cards.
  • Please select Child 7's top five interests
  • Are you finished?

    Please make sure all of your information is correct. If you have finished your application, please click submit.
  • Should be Empty: