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__________
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.                          
project.angel@sbcglobal.net