2020 Holiday Partnership Assistance Application

Applications must be completed by 5 pm on November 30, 2020, with all information completed to assure processing. Incomplete or duplicate forms will not be processed. COMPLETE ONLY ONE FORM PER HOUSEHOLD ADDRESS.


Holiday food baskets and gifts are available to low-income families, seniors ad singles who qualify. Holiday Partnership will make every effort to fill your requests however completion of the application does not guarantee that you will receive items you have listed.

 

PLEASE NOTE THAT YOU WILL BE ASKED TO UPLOAD A PICTURE OR FILE documenting your financial eligibility before submitting this application. These include a picture of your EBT Card, picture of an eligibility statement from ODHS, or unemployment verification.

Indicate Number in Household/Gross Income:
Items Needed (check all that apply):
Household Demographics (Check all that apply)

List each child (0-17), Disabled and/or Senior 60+ member in the household requesting gifts. For your Wish List – Please list only 2 items as a gift suggestion ($50.00 total limit per person). We will not fill requests for computers, tablets, gaming systems, electronic games, other electronics, bicycles, or weapons

Please contact us if you have more than 7 individuals eligible for gifts.

I hereby certify the above information is true and I give permission for it to be used by Holiday Partnership organizations for the purpose of obtaining a food box and/or gifts and, if applicable to facilitate delivery if homebound. I further authorize ODHS to authorize eligibility if needed.

Please upload proof of ODHS Eligibility - examples: a picture of your EBT Card, picture of an eligibility statement from ODHS, or unemployment verification.

Upload File