Copy of UMADAOP 4th Annual "THE GIFT" CHRISTMAS TOY DRIVE

Urban Minority Alcoholism Drug Abuse Outreach Program (UMADAOP)

The Urban Minority Alcoholism Drug Abuse Outreach Program (UMADAOP) of Franklin County is excited to host our third annual Toy Drive " The Gift ". This program was created to help provide gifts to youth and families during the Christmas holiday that need assistance. In order to be eligible for this program you must have a youth and/or family member that is currently enrolled in our programs, receive our services, or have a family member that is currently incarcerated or have a history of incarceration. You must complete the application no later than November 25, 2023 to be eligible. If you have questions, please call 614-227-9694.

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* 1. Name of Parent or Caregiver

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* 2. Does your child or Children participate in any of UMADAOPF's youth or parenting programming?

Yes

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* 3. Do you have a child who has a parent incarcerated?

Yes

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* 4. What are the name (s), ages, and gender of your Children?

First Child

Second Child

Third Child

Fourth Child

Fifth Child

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* 5. Name three things on each child's wish list

Child 1 wish list

Child 2 wish list

Child 3 Wish list

Child 4 Wish list

Child 5 Wish list

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* 6. What is your child(ren)'s clothing sizes (top, bottom)

Child 1 Sizes

Child 2 Sizes

Child 3 Sizes

Child 4 Sizes

Child 5 Sizes

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* 7. Please complete the contact information below

Name

Company

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number