GOODFELLOWS SUPPORT APPLICATION

The decision to seek assistance is based out of necessity and often a difficult choice by our community of proud families. The Dearborn Goodfellows are respectful of this decision which is why personal privacy is of the utmost importance to our organization. Any personal information shared is confidential in nature and will not be disclosed to any outside individual(s) or organization(s) without the expressed consent of the applicant. Please take comfort in knowing that sharing your family’s need will result in Dearborn Goodfellows helping your children!

Please visit the Community Aid page for additional resource information


Support applications for the 2014 season are now being accepted. Please fill out the form below.

Submit the following information about the person filing this application:

Name

Address

Phone Number

Email

Relationship to child or children

Complete the following about the parents of the child/children:

Father's name

Address

Phone Number

Email

Mother's name

Address

Phone Number

Email

Complete the following about the child/children:

Child One

Child's Name (required)

Child's Age (required)

Child's Sex (required)

Child's School (required)

Child Two

Child's Name

Child's Age

Child's Sex

Child's School

Child Three

Child's Name

Child's Age

Child's Sex

Child's School

Child Four

Child's Name

Child's Age

Child's Sex

Child's School

Child Five

Child's Name

Child's Age

Child's Sex

Child's School

Child Six

Child's Name

Child's Age

Child's Sex

Child's School

Children's Address

Please describe the type of assistance for which the Dearborn Goodfellows may be of service
 Christmas Gifts Other

If other, fIll below

We wish you the Merriest Christmas, Happiest Holidays, and a safe and Happy New Year!

 

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