Fillable Sweeny Police Department Operation Blue Santa Application (City of Sweeny)

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Sweeny Police Department Operation Blue Santa Application (City of Sweeny)

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BROWSE CITY OF SWEENY (TX) FORMS

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FOR OFFICE USE ONLY
Application Received by
____________________
Date ________________
Status_______________
Sweeny Police Department
Operation Blue Santa Application
APPLICANTS MUST LIVE WITHIN THE SWEENY SCHOOL DISTRICT AREA
DEADLINE FOR SUBMISSION: NOVEMBER 10, 2017
PLEASE NOTE THAT SUBMITTING THE APPLICATION IS NOT AN AUTOMATIC ACCEPTANCE FOR ASSISTANCE
Applicants Name /Spouse ____________________________________________________________________________
Physical Address ____________________________________________________________________________________
Contact Phone Number (2) ___________________________________ _______________________________________
Proof of Residency: Utility Bill Other _____________________
NAME ON PROOF OF RESIDENCY MUST MATCH THE NAME OF THE APPLICANT
Have you applied or do you plan to apply at any other helping organization for assistance this holiday season? ___Yes ____No
Where have/are you applying? _______________________________________________________________________
EMPLOYER: ________________________________________________________________________________________________
TOTAL INCOME (WORK, SSI, VA ETC…) ___________________________________________________________________________
Are you in Section 8 Housing? Y N
COMPLETE DETAILS BELOW OF ALL CHILDREN 13 YEARS AND YOUNGER WHO RESIDE IN THE HOME
***MUST PROVIDE COPY OF REPORT CARD OF EACH CHILD ***
FAILURE TO DO SO WILL AUTOMATICALLY DENY YOUR APPLICATION WITHOUT NOTICE
PLEASE EXPLAIN WHY YOU ARE REQUESTING ASSISTANCE: _________________________________________________
__________________________________________________________________________________________________
IF YOU HAVE APPLIED ANY TIME WITHIN THE PAST THREE (3) YEARS,
YOU WILL NOT QUALIFY FOR THE 2017 BLUE SANTA PROGRAM.
I UNDERSTAND THAT FALSE OR MISSING INFORMATION WILL CAUSE MY APPLICATION TO BE REJECTED
WITHOUT NOTICE. MUST PROVIDE ALL DOCUMENTATION AT TIME OF APPLYING.
_________________________________ _________________
Signature of Applicant Date
PICKUP TIME & LOCATION:
SWEENY COMMUNITY CENTER ON
DECEMBER 17, 2017 FROM 12 PM – 2 PM ONLY.
Call PD to make arrangements if cannot make time
NAME
AGE
SEX
PANT SIZE
SHIRT SIZE
SHOE SIZE
WISH LIST TOY (1 ITEM ONLY)
1.
2.
3.
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Sweeny Police Department Operation Blue Santa Application (City of Sweeny)

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Completed 16 July 2020

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