If residing in shelter, please select the name of that shelter from the list below.(Required) Harbor House Father Bradley Shelter Daniel Pitino Family Shelter Ozanam Family Shelter Doretha McGregor Family Shelter House of Bread & Peace Women's Shelter Ruth's House St. Josehp's Peace Mission ERM (Men only shelter) I currenly live in my car I currently live in an abandoned house N/A
In the space above, please list what shelter you are currently residing in Kentucky or Indiana?
This information will be verified by our staff.
Priority is given to those currently living in a homeless shelter or who are currently verified as being unsheltered (living on the street or in a place not fit for human habitation)
Gender Male Female Non Binary Choose not to identify. I'm good with whatever I get. N/A
Why are you being asked this? We give out toys and gifts. We want to ensure that children, youth and young adults receive gifts meant for them. It would help to know if you need gifts and clothing for male or female or if it makes no nevermind. You do NOT have to answer this question and can leave it blank. Please understand that if you do, whatever is given is given without regard to gender identity. It just may be that what is received by your child may not be what they were expecting based on who they are as a person and individual. This question trys to honor that.
Gender Male Female Non Binary Choose not to identify. I'm good with whatever I get. N/A
Why are you being asked this? We give out toys and gifts. We want to ensure that children, youth and young adults receive gifts meant for them. It would help to know if you need gifts and clothing for male or female or if it makes no nevermind. You do NOT have to answer this question and can leave it blank. Please understand that if you do, whatever is given is given without regard to gender identity. It just may be that what is received by your child may not be what they were expecting based on who they are as a person and individual. This question trys to honor that.
Gender Male Female Non Binary Choose not to identify. I'm good with whatever I get. N/A
Why are you being asked this? We give out toys and gifts. We want to ensure that children, youth and young adults receive gifts meant for them. It would help to know if you need gifts and clothing for male or female or if it makes no nevermind. You do NOT have to answer this question and can leave it blank. Please understand that if you do, whatever is given is given without regard to gender identity. It just may be that what is received by your child may not be what they were expecting based on who they are as a person and individual. This question trys to honor that.
Additional Dependents
If you have more than 3-dependents, please list their information in the space above.