"No Child Without A Christmas"

                         THE LAST DAY TO SUBMIT A LINCOLN PARK 
                         FAMILY FOR ASSISTANCE IS DECEMBER 1st.

Request assistance for a Lincoln Park family

In this area, please enter in as much information as possible.  Lincoln Park Goodfellows understands that you may have limited information regarding the family needing assistance, but we must have a telephone number for the family.
Submission does not guarantee approval for assistance.

First Name:
Last Name:
Address Street 1:
Address Street 2:
Zip Code: (5 digits)
Daytime Phone:
Evening Phone:
Person or Agency submitting this assistance request:
Best time to contact family:
Please include Comments:

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