JCMA 2025 Christmas Bureau Application

JCMA 2025 Christmas Bureau Application - Children

When: Friday, December 12
Where: First Baptist Church, 404 Juniper Dr., Holton

You must be a resident of Jackson County Kansas to apply.

Applications are due no later than Friday, November 14.
Incomplete applications will NOT be accepted.
Acceptance is based on total household income.

If you have printed this form, please mail or drop off the completed application to First Baptist Church (404 Juniper) or Holton Post Office (328 Pennsylvania).

You must attach one of the following for proof of income eligibility:
1. (ages 0-5) copy of current WIC receipt
2. SNAP Verification (front and back of your signed Vision Card)
3. Proof of income for household (bank statement, SSI Benefit Statement or last 3 months of paycheck stubs) - Must show total income for household.
***You must also attach the following: Driver's License or current photo ID***

If you qualify for the Christmas Store, you will receive notification by text, email, phone or mail no later than December 1. The notification will include a number assigned to your family. Please keep track of this number as you will need it to pick up your items on December 12.

We will be doing drive-thru for picking up your items. Please arrive at the church between 8:00 am and 2:00 pm. There will be parking lot attendants to help direct you for picking up your items. Be prepared to give your name and assigned number.

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Each qualifying household will receive a food basket, an essential bag and gifts per qualifying child.

If you have any questions, please call Jennifer Ingels at 785-851-1011 or Gayle Moulden at First Baptist Church at 785-364-3423.
Full Name*

First NameLast Name
Phone Number*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail
example@example.com
Total # of Adults in Household*
Total # of Children in Household*