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Broaddus Christmas Fund
Broaddus Christmas Fund
Misty Mitchell
Wednesday, November 20, 2019

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Town of Broaddus and Outdoor Freedom Network Inc  1011 FM 2558 Broaddus, TX 75929  (936) 872-3303 (936) 596-5935  BROADDUS CHRISTMAS FUND  APPLICATION FORM  Please fill out the form and return it to the Town of Broaddus Community Center no later than December 2rd, 2019 at 4:00. You May Pick up the gifts from the Broaddus Community Center December 20th, 2019. Participants will be chosen based on the federal poverty guidelines and first come first serve basis. Age limitation is 0 to 12 grade.  PLEASE PRINT LEGIBLY  Parents or Guardian Name:  Address  Phone # Home  Cell  Other Contact Information  Disability  School and Teachers Name  NAME  GRADE  A06  SEX  WEIGIIT  SHIRT SIZE:  PANT SIZE  favorite Color  -  Please add additional children on the back.  Parent Signature:  Monthly Income:  Date received by the Town of Broaddus  If child needs a coat please fill out:  NAME  SIZE  WEIGHT  COATS WILL BE PROVIDED IF FUNDING IS AVAILABLE