Request Help | Christmas In April C

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Assistance Application Form

If you are interested in requesting support from Christmas in April Calvert County, please fill out the form below. If you would prefer to print the application, please click the button below.

Assistance Applications for 2024 are DUE September 30, 2023

Please Note:

Due to financial constraints, Christmas in April Calvert County Inc is NOT accepting applications for Wells and Septic Systems.

ONLY Calvert County residents will be eligible.

You can apply on behalf of a homeowner with consent.

Assistance Application Form

Homeowner(s) Names - ALL Homeowners must live in home.

Home Address

Mailing Address

Phone

Email Address

Directions to home:

House Type and Age of House

How many people live in the home?

Resident Information - Please list all persons living in home.

Person 1: Homeowner Name

Person 1: Race*

Person 1: Age

Person 1: Income

Person 2: Name, Relation to owner

Person 2: Race*

Person 2: Age

Person 2: Income

Person 3: Name, Relation to owner

Person 3: Race*

Person 3: Age

Person 3: Income

Person 4: Name, Relation to owner

Person 4: Race*

Person 4: Age

Person 4: Income

*In order to comply with reporting requirements, you are asked to identify your race. This information will not be used for, or have any effect on, selection decisions.

Description of work requested (List by priority)

If Other, please specify:

Please give name(s) of the legal homeowner(s):

Additional Comments or Questions

APPLICATION SUBMITTED BY:

DATE

Phone

Email Address

Address

Thanks for submitting!