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Christmas Assistance

Mercy and Truth Christmas Assistance Application

Below you will find the application form for our Christmas assistance program.

Christmas Assistance Application

What’s your name?

What’s your childs name?

What’s your physical address?

What’s your phone number?

What’s your childs age?

What’s your childs gender?

What’s your childs race?

What’s your childs height & weight?

Do you give us permission to take photos to use for purposes of raising money for this program?

We Need Your Support Today!

Phone: 336-469-6976

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Enter your email here

Thanks for submitting!

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