TWOI Christmas Assistance Registration
Please complete this form if you need assistance with gifts for the Christmas holiday. Families may only receive assistance from one community agency and TWOI will work with other local organizations to verify that your family has not been served elsewhere. Each family requesting assistance MUST complete an intake with our Family Navigator. Once this form is complete, our Navigator will reach out to schedule that appointment with you. Families who do not attend their intake appointment will not be provided gifts for at Christmas.

Registration will be open from August 15th through October 28th. This assistance is available to families in Carroll County only. 

En español: https://forms.gle/K1gdmgeteb9CKt766
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Name of Head of Household
Address (must include #, Street & City)
Phone Number
Email Address
Name of Referring Agency
Email of Referring Agency
Additional Comments by Referring Professional (if any)
Total # of Children (under 18) Living in the Home
Total # of Adults (18+) Living in the Home
Have you applied to any other church, agency, or organization?
Clear selection
By checking yes below, you agree to have your name shared with other agencies to verify that you have not been provided gifts elsewhere.
Child #1 Name
Child #1 DOB
MM
/
DD
/
YYYY
Child #1 Shirt Size
Child #1 Pant Size
Child #1 Shoe Size
Child #1 Three Wish List Items
Child #2 Name
Child #2 DOB
MM
/
DD
/
YYYY
Child #2 Shirt Size
Child #2 Pant Size
Child #2 Shoe Size
Child #2 Three Wish List Items
Child #3 Name
Child #3 DOB
MM
/
DD
/
YYYY
Child #3 Shirt Size
Child #3 Pant Size
Child #3 Shoe Size
Child #3 Three Wish List Items
Child #4 Name
Child #4 DOB
MM
/
DD
/
YYYY
Child #4 Shirt Size
Child #4 Pant Size
Child #4 Shoe Size
Child #4 Three Wish List Items
Child #5 Name
Child #5 DOB
MM
/
DD
/
YYYY
Child #5 Shirt Size
Child #5 Pant Size
Child #5 Shoe Size
Child #5 Three Wish List Items
Child #6 Name
Child #6 DOB
MM
/
DD
/
YYYY
Child #6 Shirt Size
Child #6 Pant Size
Child #6 Shoe Size
Child #6 Three Wish List Items
Child #7 Name
Child #7 DOB
MM
/
DD
/
YYYY
Child #7 Shirt Size
Child #7 Pant Size
Child #7 Shoe Size
Child #7 Three Wish List Items
Child #8 Name
Child #8 DOB
MM
/
DD
/
YYYY
Child #8 Shirt Size
Child #8 Pant Size
Child #8 Shoe Size
Child #8 Three Wish List Items
Are there any other needs for the family such as food, clothing, hygiene or household products?
Submit
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