Application Form

Application Form - Deadline : December 8th, 2023

Como Lions Heart Inc

Family Criteria

Our team at Como Lions Heart Inc strives to make our application process as convenient as possible. Fill out our application form below to get started.

Family must be receiving one of the following - Free or reduced lunch, Medicaid, TANF, or SNAP.
Birth certificates for eligible children (may substitute shot records, Medicaid awards letter, or school records).
Children must live in applicant's residence.
Must have proof of residency (utility bill, lease, etc.)
Must have a picture ID.

Christmas Program Application Form

Name:*

Telephone Phone:*

Address*

City/State/Zip Code:*

Email Address:

Alternate Phone Number:

If you are unable to pick-up alternate name:

Total Number in Household

Check the one that applies to your family.

Free Text

LIST ONLY CHILDREN 13 & UNDER

Name | Age | M/F*

Free Text

I understand that I will be submitted to the Holiday Tracking system and if found to have gone to another agency, I will not receive gifts from agency. I further understand that these are donated toys and I will be given what is available. I further understand that this agency is not responsible or liable for anything that happens as a result of my child/children receiving these toys.