Toy Fund application TEST – Portland Press Herald

PART 1: Family information (gifts will be provided only to one parent or legal guardian)

Name

First



Last

Contact information(Required)

* I understand that I may be contacted by the Toy Fund staff to verify or clarify information.

Marital status

Please list all children living with you and in your custody

Child 1

First



Last

Name

Relationship



Gender

Child 2

First



Last

Name

Relationship



Gender

Child 3

First



Last

Name

Relationship



Gender

Child 4

First



Last

Name

Relationship



Gender

Child 5

First



Last

Name

Relationship



Gender

Child 6

First



Last

Name

Relationship



Gender

PART 2: Statement of need (REQUIRED)

B) Please provide your monthly income and expenses:

C) I have determined that due to my financial circumstances, I need assistance from the fund. I agree that all gifts received will be given to the children listed on this application and not used for any other purposes. (After your application is processed, you will receive information about when and where to pick up your toys.)

PART 3: Privacy Release

By checking this box, I give permissiomn for my application to be shared with reporters from the Portland Press Herald/Maine Sunday Telegram for possible reference/inclusion in a Toy Fun story. I understand that if I check the box, I may be contact by a reporter.

By checking this box, I give permissiomn for my application to be shared with reporters from the Portland Press Herald/Maine Sunday Telegram for possible reference/inclusion in a Toy Fun story. I understand that if I check the box, I may be contact by a reporter.

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The Portland Press Herald Toy Fund is a non-profit organization supported by the Portland Press Herald/Maine Sunday Telegram. The Toy Fund solicits money from readers and uses the money to buy new gifts for underprivileged children. The Toy Fund has served children in York, Cumberland, Sagadahoc, Lincoln, Knox and Androscoggin counties since 1949.