TOY REQUEST FORM FOR AN INDIVIDUAL FAMILY

FILLING OUT THIS REQUEST DOES NOT GUARANTEE SERVICE FOR THIS YEAR.
YOU WILL BE CONTACTED IF YOUR REQUEST CAN BE FILLED.


('◆' indicates a field where data is required.)
+                                Date: Apr 16, 2024                       +
Family last name:
Head of household
first name:
Address of Residence:
Num
Dir
Street Name
Type
Apt

City:
State:
ZIP:  
Phone:  123-123-1234
Email:
Monthly income
(whole dollars):
....

Total # of people in household:   
# of children age 13 & under:   
 *.Age..Gender..Doll color.  *.Age..Gender..Doll color.
1. 7.
2. 8.
3. 9.
4. 10.
5. 11.
6. 12.



    I am not a robot.


(blank)



* Eligibility Requirements for Receiving Toys *

◆ We serve children from infants up to 13 years old.
◆ You must live in the City of Portland (Zip codes are checked)
◆ Your income should be at or below the Federal Poverty Guidelines (list)
◆ Grandparents cannot request toys for their grandchildren unless they have legal custody.

* Toy Pickup Appointments *

◆ If approved, we will send you an email with an assigned pickup day. Due to storage space limitations, we cannot hold your toy box past that pickup day.
◆ When you come, bring photo identification for yourself and a piece of mail that shows your current address, and bring identification for each child that shows his/her date of birth. (Examples)
◆ Grandparents claiming legal custody of grandchildren must bring confirming documentation.