DEADLINE: APPLICATION AND PAPERWORK DUE IN: DATE: Nov 30th, 2017.

Wings of Doves is for children 15 and under.

Please return this application to:

Tri-Coastal Community Outreach

10520 Hwy 188, Grand Bay, AL 36541

 

(251) 865-9731 phone (251) 865- 2240 fax

E-mail carolyn@tricoastalcommunity.org


Received Date:_______________ Date Accepted/Denied:______________ Initials by: __________





PRESENTS


2016


“ ON WING OF DOVES”


Children's’ Christmas Assistance Program
( for children 15 and younger)

Date:_______________

 

Name: ________________________________________ Phone no.____________________

 

 

Current Address: _____________________________________________________________________________

 

Number of Household Members: ______ Household Income per mo.___________

 

 

Income and Address MUST BE VERIFIED.

 

Child(ren) Name Age Is this child disable

 

 

_____________________________________________________________________________________________

 

_____________________________________________________________________________________________

 

 

 

_____________________________________________________________________________________________

 

_____________________________________________________________________________________________________

 

_____________________________________________________________________________________________________

 

 

Requirement ** A BIRTH CERTIFICATE, CUSTODY PAPERS OR DOCUMENTATION THAT PROVES ALL Children listed ABOVE
LIVE IN YOUR HOUSEHOLD.