The Salvation Army of Fond du Lac Coats for Kids Registration Form

If you would need The Salvation Army of Fond du Lac’s assistance providing coats for your children, please complete this online form. To ensure the safety of all, there are no in person sign ups this year, only online.

*Adult coats for parents or adults within the family will be provided, if needed, on a first-come-first-served basis. This means that if we have extra coats donated to us that are above and beyond what we need for those under 18 years of age who have been registered, these can be chosen from by the adults. PLEASE keep in mind that these coats are very generously donated to us by community members and are intended for those who truly need this service.

*If there is a barrier preventing you from completing the application online, call the office at (920) 923-8220.

To be eligible, you must:

Be the head of the household applying for children aged 0 – 18 years-old living at home and under your care/guardianship (18-year-olds must be graduating High School in Spring 2023);
Live in Fond du Lac County (excluding Ripon);
NOT be receiving duplicate assistance from another agency, church or organization;
AGREE to the terms and conditions at the end of this form.

Directions:

Please complete all of the required information to the best of your ability.
If two families live together in the same house, each family needs to register separately.

APPLICATION DEADLINE: OCTOBER 31st

Please note: A CONFIRMATION WITH INFORMATION ON DISTRIBUTION WILL BE SENT TO THOSE WHO QUALIFY FOR THIS YEAR’S PROGRAM.

Parent/Guardian Name

Country

Address

City, State and ZIP Code

Email (ENSURE ACCURACY - Confirmation will be sent to this email address)

Date of Birth

Gender

Male
Female

Ethnicity

Phone Number

Alternate Phone Number

Is there a second adult in the household?

Current Total Monthly Household Gross Income. Example: $1,550.00

Number of Children in Household

Documentation and Certification

Terms

-I certify that the information provided above is true and accurate. I realize that program determination is at the discretion of The Salvation Army. I understand that my responses will help guide selections for my child/ren and are not guaranteed.
-I authorize The Salvation Army to share with other social service agencies to avoid duplication and understand I will receive assistance for Coats from only one agency.
-I understand that my registration is not fully complete/confirmed until I receive my confirmation. That confirmation will include distribution information.

I, the undersigned, agree to the terms above.

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