Holiday Assistance Application

How many people reside in your household ?
Date of Birth
Do you wish to receive a text alert regarding your request? Message and data rates may apply.
Please list the full names and dates of birth for all children (18 or under) residing in your household:

By checking this box I certify that all information provided as part of this application is true and correct to the best of my knowledge. I am applying on behalf of children who reside in my household for most or all of the school year. I certify that Matthews HELP Center is the only organization providing this service for my family.

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