Add Family Add New Family Step 1 of 2 50% HiddenDate Created MM slash DD slash YYYY ProgramYear RoundChristmasFirst Name Middle Initial Last Name Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Application Date* MM slash DD slash YYYY Best Number to Reach by Phone*AgeGenderMaleFemaleOptionsSelf-ShoppingSantaWarehouse PickupDeclinedNumber of Children?Ages of Children Comma separated - eg: 5,7,11Add Family NeedEmployment InformationEmployment SatusPlease SelectEmployedNot EmployedCurrent Employer If Not Emoplyed, Please Explain WhyHours Worked Per Week Monthly IncomeWagesFood StampsChild SupportMonthly Expenses (please list)REQUESTS (What kind of assistance does the applicant need?Reason Behind In Payments:Plan to Prevent Getting Behind in Payments in the Furture?Notes: Add ChildFirst Name Last Name AgeGenderMaleFemaleAdd Second ChildFirst Name Last Name AgeGenderMaleFemaleAdd Third ChildFirst Name Last Name AgeGenderMaleFemaleAdd Fourth ChildFirst Name Last Name AgeGenderMaleFemaleAdd Fith ChildFirst Name Last Name AgeGenderMaleFemaleAdd Sixth ChildFirst Name Last Name AgeGenderMaleFemale