| This form must be mailed to Project Angel 311 Production Drive Avon, Indiana 46123 To be considered for assistance |
| Must be postmarked no later than December 1, 2008 |
| Please Print Clearly All blank spaces must be filled. Date__________ |
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| You must fill this form out in its entirety. If approved, you will be eligible for assistance for no more than three (3) consecutive years. You will be notified via your telephone number listed below of the approval. If you do not have a telephone, it is your responsibility to contact us at 317-272-6100 between 9:00 a.m and 5:00 p.m. You must include proof of residence with this application. (copy of utility bill with your name on it) to be considered for assistance. List everyone who lives in your household. PROJECT A.N.G.E.L. SERVES HENDRICKS COUNTY ONLY. ALL BLANK MUST BE FILLED. |
Full Name____________________________________ Place of Employment____________________________________ Date of Birth____________ SSN__________________ Address_____________________________City_____________ Father/Spouse Full Name_____________________________Place of Employment_________________________________ Date of Birth____________SSN_________________ Address________________________________City_____________ Daytime Telephone___________________Evening/Cell Phone_________________ Household income________________ Number of total persons living in household_______________e-mail address_____________________________________ ___check if you have applied with Project A.N.G.E.L. before. ____Applied for assistance with any other organization? If approved you will be required to be home at the time of delivery, December 20, 2008 and give your signature that you have received assistance. You must have legal custody of the children on this application. I give my permission for Project A.N.G.E.L. to share my name with any not-for-profit agency who gives Christmas assistance. Must be signed and completed in Full to be considered for assistance. Any misrepresentation will be cause for denial. Signature____________________________________________________________ It is Project A.N.G.E.L.'s desire to get your child something he/she wishes for. Please indicate their "needs" also. |
| Child's full name ____________________________ age____ sex_______ Pant size____________ Shirt size____________ Weight______________ School Currently Attending ____________________________ Wish List ____________________________ ____________________________ ____________________________ |
| Child's full name ____________________________ age____ sex_______ Pant size____________ Shirt size____________ Weight______________ School Currently Attending ____________________________ Wish List ____________________________ ____________________________ ____________________________ |
| Child's full name ____________________________ age____ sex_______ Pant size____________ Shirt size____________ Weight______________ School Currently Attending ____________________________ Wish List ____________________________ ____________________________ ____________________________ |
| Please include any information you think may be helpful on the back of this application. |
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