Christmas Blessing 2024 - GRACE IN COMMUNITY CHURCH

Application form will be up soon!

* Indicates required field

Parent/Guardian Name (1) *

First

Last

What does Parent/Guardian(1) need most? *

Parent/Guardian Name (2) *

First

Last

What does Parent/Guardian(2) need most? *

Phone Number *

Email *

Number of children *

Please fill out the following section for each child!

Address *

Line 1

Line 2

City

State

Zip Code

Country

Name of Child (1) *

First

Last

Age *

Gender *

What does this child need most? *

Name of Child (2) *

First

Last

Age *

Gender *

What does this child need most? *

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