˘ ˇ ˆ A network of care teams assisting families with ... · Orange “Thanksgiving Food Box...
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PLEASE PRINT CLEARLY…………………. House Mobile Home Apartment Other 1. Home Phone: _________________________________ Contact E-Mail: __________________________________________ 2. Mobile Phone: _________________________________ Best Day/Time/Location to Contact Family: ____________________________________________________________________________ Custodian Last Name: __________________________________________ Birthdate: ______________ First Name: __________________ Spouse Last Name: __________________________________________ Birthdate: ______________ First Name: __________________ Number of people in the home: ______ Number of people under 16yrs old: _______ 3. Work Phone: _________________________________ 4. Alternate/Emergency Phone: _________________________________ Does an adult in the home speak English well? YES NO Special Information or Circumstances: ____________________________________________________________________________ Home Delivery Address: __________________________________________ City: ___________________ Zip: _____ 1. Applicants agree NOT to seek or accept holiday assistance from any other agency. Your information will be shared with other agencies in the county to ensure each family is served by only one source. 2. Applicants who lack required forms and documents will be not be registered until all required information is processed. 3. Program participation is limited to children birth up to 15 yrs. 4. The YMCA will attempt to assign a Care Team to each household and corresponding participant(s) needs. 5. Prior to December 20th, Care Team participants will contact applicants directly about delivery arrangements for gifts at a time when the children are unlikely to be at home . To pick up unwrapped gifts at the YMCA, the custodial applicant must present identification and/or your program receipt . If a Care Team is not assigned, the custodial applicant will be responsible for picking up all unwrapped gifts at a designated location by Dec 8th - 15th. 6. Children are not to know the gifts are from the YMCA or any other agency. 7. It is the applicant’s responsibility to call 770-888-2788 if there is any change in registration information (phone, address, etc..). Care teams cannot contact applicants without the proper contact information. 8. Sizes must be requested in U.S. Sizes, not Latin Sizes. 9. Wish lists items are not to include designer clothing or high-end products such as ipods, Xbox, iphones, PC’s etc…. Applicant Signature: __________________________________________________ Date: ______________________ • Appointments are not required. For personal assistance, appointments can be scheduled in advance by calling 678- 341-6337. However, allocate a minimum of 45 minutes to enroll, Start to Finish • Children accompanying applicant during registration must utilize free childcare and arrive 45 minutes prior to close of childcare hours. See hours posted below. Children needing childcare must not be sick or have a fever. • Participants MUST provide copies of the “REQUIRED FORMS & DOCUMENTS” listed below. Paperwork cannot be processed without. • FORMS & DOCUMENTS require one document from “List A” or a document from “List B” and “List C” • Wait-list registration does not guarantee enrollment in the program. Wait-list participants will be based on gift availability. Open Application Enrollment No Guarantee of Gifts Hours of Registration FREE Childcare Available After November 21st (No Guarantee of Gifts) Mon- Fri 8:30 am - 9:00 pm 8:30 am - 1:15 pm 3:30 pm - 8:00 pm Saturday 8:30 am - 5:30 pm 8:30 am - 1:00 pm Sunday 1:30 pm - 5:30 pm Closed October 1 thru November 21st Program registrations can be submitted beginning October 2 thru November 15th, Tuesday –Thursday, 8:00 am until 12:00 noon and 1:00 pm until 4:00 pm at the Hill Education Center / Transition Services Office, 136 Elm Street., Cumming, GA 30040, Phone: 678-947-0274. Once a complete enrollment application is received by the YMCA, a confirmation receipt will be sent to confirm enrollment in the YMCA Holiday Giving Tree for Kids program. A Documents Below to Establish Both Identity/Forsyth Residency and Household Income/Salary 1. Orange “Thanksgiving Food Box Card” as record of support from The Place of Forsyth County. 2. Recent/valid record of support from Ninth District Opportunity, Inc.. 3. Recent/valid approval letter for Food Stamps 4. Recent/valid approval letter from housing authority for subsidized housing 5. Recent/valid approval letter for Medicaid 6. Recent/valid approval letter for Peachcare for Kids A Document(s) to Establish Each Child’s Identity and Forsyth Residency AND A Document(s) to Establish Household Income / Salary 1. Photo ID and Utility bill within last 30 days. 2. Copy of child’s Forsyth County School “student summary page” from Forsyth County Schools 1. Proof of household income from last 30 days to include: * Last 4 pay stubs if paid weekly. 2 if paid bi- weekly/semi-monthly. * Proof of all public assistance (Food Stamps, SSA, TANF, Child Support, etc... 2. W-2 or 1090 form from prior year tax return Address: 6050 Y Street Cumming, GA 30040 Gifting Hotline: 678-341-6337 Website: fcy.ymcaatlanta.org !" Exit 13 from GA 400 north, go west on Hwy 141 across Atlanta Hwy (Hwy 9) onto Be- thelview Rd. Go 1 mile to the light at Be- thelview & Castleberry. Left onto Castleberry Rd. and go to next light at Ma- jors Rd. Turn right onto Majors Rd. through the Polo Fields till you end at the traffic light at Post Rd. YMCA is ahead in Vickery subdivision. #!" Take Exit 12b from GA 400 south, onto McFarland Rd. Turn right on Union Hill Rd. Go to light, turn left onto Mullinax Rd. Continue onto Post Rd. at light. (Wendy’s on left). Go 2.1 miles, turn left into Vickery at Majors Rd stop light. $%!#&% ’()% *)&()) +#,’(&-&-. ’&$((&-/(,-$ 00(,- 12#3(’)&)%" Holiday Giving Tree for Kids is organized thru the YMCA but made possible by a network of local busi- nesses, corporations, churches and civic groups through- out Forsyth County. Volunteers are employees, patrons and community servants sharing their time, talent and treasures to support the less fortunate in their community and express their care and concern for those surviving crisis or hardship. Care team volunteers strive to provide relief to strug- gling families with youth by providing clothing, toys, school supplies and gifts of joy during the holiday sea- son. We bring hope and encouragement to children and families who, most of all, need to believe in a community that cares! A network of care teams assisting families with children in Forsyth County with gifts of joy for children during the holiday season. !"# !! $% % & ’()*)+ ’(,)*-)+ +.(*/0’((+’’(1 )23*4’’+/*(*4(5-6)+7-8), )23*4’’+(-)*’)9(*4(5-’2,’+- . 4 54 : ; # #< $< #<= (1) Child Name: ______________________________________________ Birthdate: ______________ Girl:__________ Boy:__________ Wish List Description (2-3 Item Maximum): _____________________________________________________________________________ Comments re. Special Sizes : _____________________________________________________________________________ Relation to Custodial Applicant: ______________________________________________ School Child Attends: _____________________________ Coat Size:______ Pant Size:______ Undergarment Size: _______ Shoe Size:_____ Shirt Size:_____ 4th:___________ 1st:___________ Items Needed Most: 3rd:___________ 2nd:___________ (2) Child Name: ______________________________________________ Birthdate: ______________ Girl:__________ Boy:__________ Wish List Description (2-3 Item Maximum): _____________________________________________________________________________ Comments re. Special Sizes : _____________________________________________________________________________ Relation to Custodial Applicant: ______________________________________________ School Child Attends: _____________________________ Coat Size:______ Pant Size:______ Undergarment Size: _______ Shoe Size:_____ Shirt Size:_____ 4th:___________ 1st:___________ Items Needed Most: 3rd:___________ 2nd:___________ (3) Child Name: ______________________________________________ Birthdate: ______________ Girl:__________ Boy:__________ Wish List Description (2-3 Item Maximum): _____________________________________________________________________________ Comments re. Special Sizes : _____________________________________________________________________________ Relation to Custodial Applicant: ______________________________________________ School Child Attends: _____________________________ Coat Size:______ Pant Size:______ Undergarment Size: _______ Shoe Size:_____ Shirt Size:_____ 4th:___________ 1st:___________ Items Needed Most: 3rd:___________ 2nd:___________
Transcript of ˘ ˇ ˆ A network of care teams assisting families with ... · Orange “Thanksgiving Food Box...
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PLEASE PRINT CLEARLY………………….
�House �Mobile Home �Apartment �Other 1. Home Phone: _________________________________
Contact E-Mail: __________________________________________
2. Mobile Phone: _________________________________
Best Day/Time/Location to Contact Family: ____________________________________________________________________________
Custodian Last Name: __________________________________________
Birthdate: ______________
First Name: __________________
Spouse Last Name: __________________________________________
Birthdate: ______________
First Name: __________________
Number of people in the home: ______ Number of people under 16yrs old: _______
3. Work Phone: _________________________________4. Alternate/Emergency Phone: _________________________________
Does an adult in the home speak English well? �YES �NO
Special Information or Circumstances: ____________________________________________________________________________
Home Delivery Address: __________________________________________ City: ___________________ Zip: _____
1. Applicants agree NOT to seek or accept holiday assistance from any other agency. Your information will be shared with other agencies in the county to ensure each family is served by only one source.
2. Applicants who lack required forms and documents will be not be registered until all required information is processed. 3. Program participation is limited to children birth up to 15 yrs. 4. The YMCA will attempt to assign a Care Team to each household and corresponding participant(s) needs. 5. Prior to December 20th, Care Team participants will contact applicants directly about delivery arrangements for gifts at a
time when the children are unlikely to be at home. To pick up unwrapped gifts at the YMCA, the custodial applicant must present identification and/or your program receipt. If a Care Team is not assigned, the custodial applicant will be responsible for picking up all unwrapped gifts at a designated location by Dec 8th - 15th.
6. Children are not to know the gifts are from the YMCA or any other agency. 7. It is the applicant’s responsibility to call 770-888-2788 if there is any change in registration information (phone, address,
etc..). Care teams cannot contact applicants without the proper contact information. 8. Sizes must be requested in U.S. Sizes, not Latin Sizes. 9. Wish lists items are not to include designer clothing or high-end products such as ipods, Xbox, iphones, PC’s etc…. Applicant Signature: __________________________________________________ Date: ______________________
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���������������� ���� �������������• Appointments are not required. For personal assistance, appointments can be scheduled in advance by calling 678-
341-6337. However, allocate a minimum of 45 minutes to enroll, Start to Finish • Children accompanying applicant during registration must utilize free childcare and arrive 45 minutes prior to
close of childcare hours. See hours posted below. Children needing childcare must not be sick or have a fever. • Participants MUST provide copies of the “REQUIRED FORMS & DOCUMENTS” listed below. Paperwork
cannot be processed without. • FORMS & DOCUMENTS require one document from “List A” or a document from “List B” and “List C”
• Wait-list registration does not guarantee enrollment in the program. Wait-list participants will be based on gift availability.
��������� ����������������������������������������Open
Application Enrollment No Guarantee of Gifts Hours of Registration FREE Childcare Available
After November 21st
(No Guarantee of Gifts)
Mon- Fri 8:30 am - 9:00 pm 8:30 am - 1:15 pm 3:30 pm - 8:00 pm
Saturday 8:30 am - 5:30 pm 8:30 am - 1:00 pm Sunday 1:30 pm - 5:30 pm Closed
October 1 thru
November 21st ���� ���������� �� ������������������������������
Program registrations can be submitted beginning October 2 thru November 15th, Tuesday –Thursday, 8:00 am until 12:00 noon and 1:00 pm until 4:00 pm at the Hill Education Center / Transition Services Office, 136 Elm Street., Cumming, GA 30040, Phone: 678-947-0274. Once a complete enrollment application is received by the YMCA, a confirmation receipt will be sent to confirm enrollment in the YMCA Holiday Giving Tree for Kids program.
������� A Documents Below to Establish Both
Identity/Forsyth Residency and Household Income/Salary 1. Orange “Thanksgiving Food Box Card” as record of support from The Place of Forsyth County. 2. Recent/valid record of support from Ninth District Opportunity, Inc.. 3. Recent/valid approval letter for Food Stamps 4. Recent/valid approval letter from housing authority for subsidized housing 5. Recent/valid approval letter for Medicaid 6. Recent/valid approval letter for Peachcare for Kids
��������������������������������������������������������� A Document(s) to
Establish Each Child’s Identity and Forsyth Residency
AND
A Document(s) to Establish Household Income / Salary
1. Photo ID and Utility bill within last 30 days. 2. Copy of child’s Forsyth County School “student
summary page” from Forsyth County Schools
1. Proof of household income from last 30 days to include: * Last 4 pay stubs if paid weekly. 2 if paid bi- weekly/semi-monthly. * Proof of all public assistance (Food Stamps, SSA, TANF, Child Support, etc... 2. W-2 or 1090 form from prior year tax return
Address: 6050 Y Street Cumming, GA 30040 Gifting Hotline: 678-341-6337 Website: fcy.ymcaatlanta.org ���������������� !"�Exit 13 from GA 400 north, go west on Hwy 141 across Atlanta Hwy (Hwy 9) onto Be-thelview Rd. Go 1 mile to the light at Be-thelview & Castleberry. Left onto Castleberry Rd. and go to next light at Ma-jors Rd. Turn right onto Majors Rd. through the Polo Fields till you end at the traffic light at Post Rd. YMCA is ahead in Vickery subdivision.� ���������������# !"�Take Exit 12b from GA 400 south, onto McFarland Rd. Turn right on Union Hill Rd. Go to light, turn left onto Mullinax Rd. Continue onto Post Rd. at light. (Wendy’s on left). Go 2.1 miles, turn left into Vickery at Majors Rd stop light.
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Holiday Giving Tree for Kids is organized thru the YMCA but made possible by a network of local busi-
nesses, corporations, churches and civic groups through-out Forsyth County. Volunteers are employees, patrons and community servants sharing their time, talent and
treasures to support the less fortunate in their community and express their care and concern for those surviving
crisis or hardship.
Care team volunteers strive to provide relief to strug-gling families with youth by providing clothing, toys, school supplies and gifts of joy during the holiday sea-
son.
We bring hope and encouragement to children and families who, most of all, need to believe in a community that cares!
������������������������������ A network of care teams assisting families with children in Forsyth County
with gifts of joy for children during the holiday season.
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(1) Child Name: ______________________________________________
Birthdate: ______________
Girl:__________ Boy:__________
Wish List Description (2-3 Item Maximum): _____________________________________________________________________________ Comments re. Special Sizes : _____________________________________________________________________________
Relation to Custodial Applicant: ______________________________________________
School Child Attends: _____________________________
Coat Size:______ Pant Size:______ Undergarment Size: _______ Shoe Size:_____ Shirt Size:_____
4th:___________ 1st:___________ Items Needed Most: 3rd:___________ 2nd:___________
(2) Child Name: ______________________________________________
Birthdate: ______________
Girl:__________ Boy:__________
Wish List Description (2-3 Item Maximum): _____________________________________________________________________________ Comments re. Special Sizes : _____________________________________________________________________________
Relation to Custodial Applicant: ______________________________________________
School Child Attends: _____________________________
Coat Size:______ Pant Size:______ Undergarment Size: _______ Shoe Size:_____ Shirt Size:_____
4th:___________ 1st:___________ Items Needed Most: 3rd:___________ 2nd:___________
(3) Child Name: ______________________________________________
Birthdate: ______________
Girl:__________ Boy:__________
Wish List Description (2-3 Item Maximum): _____________________________________________________________________________ Comments re. Special Sizes : _____________________________________________________________________________
Relation to Custodial Applicant: ______________________________________________
School Child Attends: _____________________________
Coat Size:______ Pant Size:______ Undergarment Size: _______ Shoe Size:_____ Shirt Size:_____
4th:___________ 1st:___________ Items Needed Most: 3rd:___________ 2nd:___________
������������������ ���������������� 1. Los aplicantes deben estar de acuerdo en no buscar ni aceptar ayuda de otras agencias. Su información será compartida con otras
agencias en el condado para asegurar que cada familia sea servida por sólo una fuente. 2. Los solicitantes que no tengan todos los documentos necesarios no serán registrados hasta que toda información necesaria sea proce-
sada. 3. La participación en el programa es limitada a niños en la escuela hasta los 15 años. 4. El YMCA procurará asignar un Care Team o patrocinador a cada hogar y se le entregara la lista de deseos del participante. 5. Antes de Deciembre 20 los Care Team se comunicaran con los padres para hacer arreglos de eutrega de regalos cuando los niños no
esten en la casa. Para recoger regalos en el YMCA sin niños, usted debe presenter identificación y/o su recibo de programa. Si un Care Team no es asignado o no se comunica con usted, el aplicante custodial será responsable de recoger todos los regalos en la YMCA 8 de Diciembre hasta 15 de Diciembre .
6. Los niños no deben saber que los regalos son del YMCA ni cualquier otra agencia. 7. Es la responsabilidad del solicitante de llamar 678-341-6337 si hay cualquier cambio en la información (número de teléfono, la
dirección, etc..). Los Care Teams no podran contactar a los aplicantes si la informacion de contacto es incorrecta. 8. Las tallas deben ser escritas en tallas usadas el los Estados Unidos. 9. En la lista de deseos no puede incluir ropa de dise>adores exclusivos o objetos como ipods, Xbox, iphones, computadoras, etc…. Firma de Solicitante del Cutodial________________________________________________ Fetcha: _________________
�'.(2?�@'��+A)2�,(+(�*/>)-�es organizado por el YMCA, pero hecho posible con la ayuda de negocios locales, corporaciones, iglesias y grupos cívicos en el Condado de Forsyth. Los volun-tarios son empleados, patrocinadores y vecinos de la
comunidad que comparten su tiempo, talentos y tesoros para apoyar al menos afortunado en su comunidad y ex-presar su atención y preocupación por aquellos sobre-
viviendo alguna crisis o momentos difíciles. Los patrocinadores del Care Team se esfuerzan por pro-porcionar alivio a familias con niños, que estan luchando financieramente al proveerle ropa, juguetes, útiles esco-
lares y regalos que traen alegria durante la Navidad. Traemos esperanza y ánimo a niños y familias que nece-
sitan creer que la comunidad los quiere ayudar.
�B���������C�@'������,(+(���D� �Grupos de ciudadanos del Condado de Forsyth ayudan con este projecto de
regales para darles alegría a los niños durante las fiestas de Navidad.
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Por Favor Escriba Bien Claro………………….
�Casa �Tráiler �Apartmento �Otro:__________ 1. Teléfono de Casa: _________________________________
Correo Electrónico: __________________________________________
2. Teléfono Celular: _________________________________
Mejor Hora para comunicarse con aplicante: ____________________________________________________________________________
Nombre del Custodial: (Apellido) __________________________________________
Fecha de Nacimiento: ______________
(Primero): __________________
Nombre de Esposo/a: (Apellido)__________________________________________
Fecha de Nacimiento: ______________
(Primero): __________________
Número de personas en el hogar: ______ Menores de 16 años: _______
3. Teléfono de Trabajo: _________________________________ 4. Teléfono Emergencia/Otro: _________________________________
Habla un adulto en el hogar inglés bien? � SI � NO
Información o Las Circumstancias Especiales: ____________________________________________________________________________
Direccion del Hogar: __________________________________________ Pueblo: _________ Codigo postal: _____
����������������� ��� � MUY IMPORTANTE...COMO REGISTRARSE...MUY IMPORTANTE
• Citas no son requeridas. Para pedir ayuda, citas pueden ser hechas de antemano llamando al 678-341-6337. Usted necesitará un mínimo de 45 minutos para completar su solicitud.
• Los niños que acompañan al solicitante durante la matrículacion deben utilizar la guardería de niños gratis, y llegar 45 minutos antes del cierre de la guardería de niños. Ver horas disponibles abajo. Niños necesitando guardería no pueden estar enfermos o con fiebre.
• Los participantes TIENEN que proveer copia de los documentos y formularios necesarios mencionados abajo. La solicitud no puede ser procesada sin esta información.
• Los formularios y documentos requieren un documento de “Lista A” o los documentos de “Lista B” y “Lista C”. • La solicitud de la “Lista de la Espera” no garantiza matriculación en el programa. Los participantes de la “Lista de
la Espera” serán basados en la disponibilidad de regalos.
LAS HORAS DE OPERACION DE A�BOL REGALO� DE YMCA PARA NIÑOS �
Dias Para Solicitar No Garantiza Las Horas de Operación Guardería de Niños Gratis
Despues del 21 de Novembre
No Garantiza Ayuda
Lunes-Viernes
8:30 am - 9:00 pm 8:30 am - 1:15 pm 3:30 pm - 8:00 pm
Sabado 8:30 am - 5:30 pm 8:30 am - 1:00 pm Domingo 1:30 pm - 5:30 pm Cerrado
1 de Octubre a
21 de Novembre
���� ���������� �� ������������������������������Usted puede llevar su solicitud ya completada a partir del 2 de octubre hasta el 15 el noviembre al Centro de Transi-ci?*�2)E(2/0(@)�'*�#!���21� 4+''4��311/*.I��J�1(+4'-�(�K3'H'-�@'��$<<� �#L$<<�,1�)�#$<<� �"$<<�,1�� /�*'E'-/4(�(G3@(�22(1'�(2���� ="� <L�"��*(�H'0�F3'�2(-�-)2/E/43@'-�8(G(*�-/@)�+'E/A/@(�,)+�'2������G�'2�,+)E'-)�@'�1(4+ME32(�'-�E)1,2'4(@)I�3*�+'E/A)�@'�E)*9/+1(E/?*�-'+N�'*H/(@)�,(+(�E)*9/+1(+�,(+4/E/,(E/?*�'*�'2��'.(2?�@'��+A)2�@'2������,(+(�*/>)-�
������9�:� Documentos Abajo para Establecer Residencia de Condado de Forsyth
e Ingresos/Salario del Hogar 1. Naranjo para la comida del DMa de Acci?n de Gracias o prueba de asistencia de The Place 2. El registro de apoyo de Nine District Opportunity 3. Carta que pruebe que recibe las estampillas de alimentos. Traiga la carta, no la tarjeta. 4. Carta indicando que recibe subsidio de vivienda 5. Carta de aprovaci?n del Medicaid 6. Carta de aprovaci?n de los ni>os en Peachcare
������9�:���������������������������������������������������9�: Documentos para Establecer la
Identidad de Cada Niño y Residencia del Condado de Forsyth
AND
Documentos Para Declarar Ingresos / Salario del Hogar
1. Targeta de Identificación y algunas recibos de servicios de utilidades dentro de últimos 30 dias.
2. Copia de registro de matriculación de la escuela del niño o “Página de Resumen del Estudiante” de Escuelas del Condado de Forsyth.
1. Prueba de Ingresos de los ultimos 30 dias de todos los resi-dentes del hogar, incluyendo lo siguiente:
* 4 últimos talonarios o cheques de ingresos si es pagado semanalmente, 2 talonarios si es pagado quincenal.
* La prueba de toda ayuda estatal (Cupones de alimentos, SSA, TANF, la Manutención de hijos, etc…)
2. W-2 or 1090 forma de la declaraciones de impuestos del año anterior.
Dirección: 6050 Y Street Cumming, GA 30040 Línea Directa: 678-341-6337 Sitio Web: fcy.ymcaatlanta.org ��(�-,,(�&-$�+-���������+-)���� -"�Toma Salida 13 de GA 400 del norte, va al oeste en Carretera 141 a través de Carretera Atlanta (Carretera 9) en el Calle Bethelview. Continúe 1 milla a la luz en Bethelview y el Calle Castleberry. Gire a la izquierda en Castleberry. Gire a la derecha en el Calle Majors. Continúe en Majors por subdi-visión de Polo Fields hasta que usted termine en la luz de Calle Post. El YMCA está atrás de las tiendas en Aldea de Vickery, YMCA está atrás. ���(�-,,(�&-$�+-���������+-)��#�"�Toma Salida 12B de GA 400 del sur, en Calle McFarland. Gire a la derecha en el Calle Union Hill. Vaya a la luz, gire a la izquierda en el Calle Mullinax. Continúe en Calle Post en la luz (a restaurante Wendy’s). Vaya 2.1 millas, gire la izquierda en Aldea de Vickery, YMCA está atrás.
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(1) Nombre del Niño: ______________________________________________
Fecha de Nacimiento: ______________
Niña:__________ Niño:__________
Una Descripción de Lista (2-3Artículos Max): _____________________________________________________________________________ Comentarios sobre Tamaños Especiales: _____________________________________________________________________________
Relación al Aplicante: ______________________________________________
Escuela: _____________________________
Chamarra:______ Pantalón:______ Tamaño de ropa interior: _______ Zapato:_____ Camisa:_____
4to:___________ 1ro:___________ Artículos Necesarios: 3ro:___________ 2do:___________
(2) Nombre del Niño: ______________________________________________
Fecha de Nacimiento: ______________
Niña:__________ Niño:__________
Una Descripción de Lista (2-3Artículos Max): _____________________________________________________________________________ Comentarios sobre Tamaños Especiales: _____________________________________________________________________________
Relación al Aplicante: ______________________________________________
Escuela: _____________________________
Chamarra:______ Pantalón:______ Tamaño de ropa interior: _______ Zapato:_____ Camisa:_____
4to:___________ 1ro:___________ Artículos Necesarios: 3ro:___________ 2do:___________
(3) Nombre del Niño: ______________________________________________
Fecha de Nacimiento: ______________
Niña:__________ Niño:__________
Una Descripción de Lista (2-3Artículos Max): _____________________________________________________________________________ Comentarios sobre Tamaños Especiales: _____________________________________________________________________________
Relación al Aplicante: ______________________________________________
Escuela: _____________________________
Chamarra:______ Pantalón:______ Tamaño de ropa interior: _______ Zapato:_____ Camisa:_____
4to:___________ 1ro:___________ Artículos Necesarios: 3ro:___________ 2do:___________
