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Registration for Operation Christmas 2018

  1. REGISTRATION INFORMATION

  2. Important Please Read:

    The person registering must match name on water bill to verify residency. If renting please provide property owners name for verification.

  3. (If applicable)

  4. Contact Information:

  5. Preferred Method of Contact:*

  6. Are you able to receive text messages at this number?

  7. Can we leave a voicemail at this number?

  8. Can we send information to your email address?

  9. Do you participate in Supplemental Nutrition Assistance Program (SNAP) or Women, Infant and Children Program (WIC)?*

  10. Have you participated in this program before?*

  11. Do you prefer presents wrapped or not?*

  12. Gifts can be picked up at Village Hall, 1050 W. Romeo Rd. on Friday, December 21st. Please indicate which time would work best for you to pick up your gifts. A confirmation time will be sent to you as to when to pick up your gifts.

  13. ADULT INFORMATION

  14. Name, ages and last 4 digits of social security number of all adults over 18 years old in household

    (Please indicate if any of the adults are veterans, currently serving, deployed or retired)

  15. CHILDREN INFORMATION

  16. Please provide clothing sizes for children ages 12 and under, as well as toy or gift ideas. We suggest providing a wide range of toy/gift ideas to make it easier for donors. Youth ages 13-18 will receive gift cards so please list store ideas.

  17. Sex

  18. Sex

  19. Sex

  20. Sex

  21. Sex

  22. Sex

  23. Leave This Blank:

  24. This field is not part of the form submission.