Alpha Iota 15th Annual Thanksgiving Outreach Application

23rd Annual Thanksgiving Outreach Application

You can apply for a meal online or you can also download the form here and mail it to:

Thanksgiving Outreach

Or you can proceed to apply online....

Contact Information:

First and Last Name:

Street Address:

Email Address:

City:

Phone Number:

State:

Alternative Number:

Zip Code:

Are you a single parent?

My family is Supported by:

Yearly Income:

Household Size:

1. Name & Age of child:

2. Name & Age of child:

3. Name & Age of child:

4. Name & Age of child:

5. Name & Age of child:

6. Name & Age of child:

If needed, would you be interested in picking up your meal on November 25th at YMCA Great Long Beach at 7pm at 525 East 7th St. Long Beach, CA 90802?

Could your family use financial assistance during the holidays? Please write a brief history about your family so that we can get to know you and your family better.

I certify the information I have provided is true and correct to the best of my knowledge. All information is subject to verification. Falsification of information will disqualify applicants. Remember, if you exaggerate information and are rewarded a meal, you could be taking from a truly needy family. Your honesty is greatly appreciated.

Agreement Yes, I have read the above statement and certify that the above information is true.