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Town of Winchester
CHRISTMAS FOR KIDS
2007
___________________________________________/______________________
LAST NAME FIRST
MARITAL STATUS: SINGLE ___ SEP___ MARRIED___ DIV ___ WIDOW(ER)___
ADDRESS:____________________________________________________________
OCCUPATION:______________________EMPLOYER:______________HOW LONG?____
TELEPHONE: HOME______________WORK_______________OTHER________________
CHILDREN: AGE GIRL/BOY
1
2
3
4
5
OTHERS IN HOUSEHOLD: NAME AND RELATIONSHIP
IS WINTER CLOTHING NEEDED? (IF SO, WHAT ITEMS AND SIZES)
PLEASE GIVE A SHORT SUMMARY OF WHY YOU ARE APPLYING FOR GIFTS (JOB LOSS, ETC)
PARENT/GUARDIAN SIGNATURE______________________________DATE___________
AGE LIMIT IS NEWBORN THROUGH 12 YEARS OLD
PLEASE RETURN THE COMPLETED APPLICATION BY DECEMBER 2, 2007 TO THE TOWN HALL, AT EITHER THE BOARD OF SELECTMEN’S OFFICE OR WITH PEG TATRO, WELFARE DIRECTOR
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