Date: Business/Partner Name: Contact Name: Contact Phone #:
Address:
Email: City: Zip:
List of Items
How Many Items
Boys / Girls/ Unisex
Ages Group
Games
Dolls
Art Supplies
Books
Athletic Balls & Supplies
Electronics
Bath/ Beauty Supplies
Gift Cards
Other Toys
Other Items
We your business and/or you be attending the event. YesNo
Will your business and/or you volunteer with decoration, set-up, clean up for this event. YesNo
Partner Signature:
Date:
Revised Nov 2024
Date: Recipient Name: Last (4) SSN#: Address: Phone: City: Zip: Email: # in Family:
Kids
First NAME
Last Name
Last (4) of SSN#
Age
Gender
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
Total # Boys:
Total # Girls:
I, do hereby authorize TWAM to disclose to any community group, partners, and/or agency information from this application & pertaining to myself and/or of the above names regarding holiday assistance.
