PINE COUNTY OFFICIAL “Toys for Tots” Family Application

PINE COUNTY OFFICIAL “Toys for Tots” Family Application
Applications are only available for custodial parents. Only 1 application per family.
Drop off at the following locations: WIC office (Pine City), P.C. Food Shelf, Family Pathways Food
Shelf (Hinckley, Sandstone), Pine County Health & Human Services (P.C. Courthouse or John
Wright Building in Sandstone), Our Redeemer Lutheran Church in Pine City.
Name:
Phone:
Address:
City:
State: MN
County: PINE
Zip:
Have you ever applied to Pine County Toys for Tots before: YES________ When?_______ NO:____
Have you applied for any other toy distributions programs? YES:_____ Program applied
for ____________________________. NO _____
Please enter children’s names/ages below. Only children from age 1-12 are eligible. Children must live
at address provided above.
First Name
Middle
Initial
Last Name
Age
Boy/Girl
Gift
Suggestions
Boy/Girl
Boy/Girl
Boy/Girl
Boy/Girl
Boy/Girl
Check here if additional children _______. Write information on the back of this form.
Estimated family income for 2014: ______________ (applicant may be asked to ver ify income statement)
I understand that gifts are NOT guaranteed and are dependent on donations. I also understand that I
may be asked to verify any and all information I have provided Pine County Toys for Tots.
Applicant Signature: _______________________________________________________
Distribution will occur on December 20th from 8:30-noon only. Tear off below as your reminder. If
you cannot personally attend; send your reminder sheet and a note of authorization with someone
who can come for you. There will NOT be any reminder postcards.
APPLICATION DEADLINE is December 12th, 2014—NO Exceptions.
TEAR OFF THIS PORTION AND KEEP—IT IS YOUR ONLY NOTICE.
You are invited to pick up your gifts on Saturday, December 20th between 8:30 and 12noon. There are no
appointments this year. All gifts are selected by volunteers and the type/amount of gifts you will receive
depends solely on donations. The age limit for children to receive gifts is 12 yrs.
Those living north of Hinckley to the North boundary of Pine County: Come to the Finlayson Community Center, 2195 Finland Ave, Finlayson, MN
If you live in Hinckley south to Pine City (south Pine County): Come to Our Redeemer Lutheran
Church, 825 Golf Ave SW, Pine City MN.
If you cannot come due to work etc. send a note of permission with someone to come in your place.