| Date: | Nov 13, 2025 | ||||||||||||
| ◆ Family last name: | |||||||||||||
| ◆ Head of household first name: | |||||||||||||
◆ Address of Residence:
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| ◆ City: | |||||||||||||
| ◆ State: | |||||||||||||
| ◆ ZIP: | Auto-filled, click to verify. | ||||||||||||
| ◆ Phone: | 123-123-1234 | ||||||||||||
| ◆ Email: | |||||||||||||
| ◆ Monthly income (whole dollars): | |||||||||||||
| Total # of people in household: | |||||||
| # of children age 13 & under: | |||||||
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* Program Notice *
◆ You may find that the Zipcode lookup feature claims that it can't find your address. This may be due to a new limitation imposed by USPS on how frequently we are allowed to make lookup requests. If this happens to you, try waiting for 2 hours and then submit this form again.* Communication Notice *
◆ We use email as our primary form of communication.* Eligibility Requirements for Receiving Toys *
◆ We serve children from infants up to 13 years old.* Toy Pickup Appointments *
◆ If approved, we will send you an email with an assigned pickup day. Due to storage space limitations, we cannot hold your toy box past that pickup day.