Toys For Happiness Assistance Application

Tri-State Toys For Happiness Inc. Electronic Registration Form

 

Rules for application: (ALL BLANKS must be completed. Indicate "NO or "NONE" if necessary. Incomplete applications may delay processing)

 

ONLY PARENT or LEGAL GUARDIAN can submit this application; NO Foster Parents

Child MUST reside with parent/guardian at the time of completing application

Only childred 15 years or younger will be accepted

One form must be completed for per child

Applicants income will be subject to verification

WE DO NOT notify you if you application is approved, ONLY IF DENIED

DEADLINE FOR SUBMITTING APPLICATIONS IS NOVEMBER 20, 2012

 

NO EXCEPTIONS WILL BE MADE TO ANY OF THESE RULES. USE FULL NAMES OF CHILDREN NO NICKNAMES. 
Last Name:
First Name:
initial:
Birth Date:
Child Social Security Number:
Sex:

Parent/Guardian name:
Parent SSN#:
Number of dependents:
Telephone Number:
Did you receive toys from Toys For Happiness Last Year:

Closest Fire Department (MUST be provided if living OUTSIDE city limits):
Mailing Address:
Physical Address:
Electronic Signature (type parent or guardian name to accept):
 
   
Privacy Notice

Your registration information is for the use of WKGO only. We collect information in order to keep you informed of contests and events sponsored or promoted by WKGO. WKGO will not sell, rent or in any way distribute personal information supplied to us by you. The information you provide us stays with WKGO only.

Tri-State Toys for Happiness has been hereby authorized to release and receive information concerning my needs to other agencies/charities interested in assisting my family with Christmas gifts. Tri-State Toys for Happiness will exercise reasonable care to protect the privacy of my family and myself. Tri-State Toys For Happiness will not be held responsible for the acts of these other agencies/charities with respect to my application kfor assistance. I also understandthat the provided informationwill be documented into a community resource database and will be shared with other agencies/charities. I further understand that Tri-State Toys for appiness will DENY assistance if anyone in my household is receiving the same assistance from another agency/charity. To the berst of my knowledge, the information provided, is true and accurate.