2021 Christmas for Lanier Kids
Application Deadline is Friday, November 12th, 2021
Each child will receive up to 3 items. C4LK should be used in addition to what you and your family plan to provide to your children for Christmas. Due to limited resources, we CANNOT guarantee that your family will receive assistance. Anyone who provides false information will be denied!
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Name of Parent/Guardian: *
Mailing Address *
Contact Number *
Email Address
Child #1 First & Last Name *
Child #1 Age *
Child #1 Gender *
Child #1 Race *
Child #1 Interest *
Required
Child #2 First & Last Name
Child #2 Age
Child #2 Gender
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Child #2 Race
Clear selection
Child #2 Interest
Child #3 First & Last Name
Child #3 Age
Child #3 Gender
Clear selection
Child #3 Race
Clear selection
Child #3 Interest
Child #4 First & Last Name
Child #4 Age
Child #4 Gender
Clear selection
Child #4 Race
Clear selection
Child #4 Interest
Do you have more than 4 children under the age of 12?
Clear selection
If you answered yes to the question above. Please leave a name and good contact number so we can call you to get more information.
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