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2025 Application
danfennell
2025-11-28T20:04:11+00:00
2025 Cheer For Children Application
Please provide as much information as possible and include contact information.
Parents Name
First
Last
Address
Street Address
City
State / Province / Region
ZIP / Postal Code
Phone
(Required)
Email
Number of Children
Childs Name)s)
Full Name
Social Security Number
Sex
Age
Add
Remove
Please do not list children over 12 years of age. Click "+" icon to add additional children
Have you received assistance from our program in the past?
Yes
No
Please list the years you received asistance from our program
Add
Remove
Do you receive assistance from another program?
Yes
No
Please provide the name(s) of those programs
Add
Remove
Do you want Santa to deliver your toys?
Yes
No
Someone form the Cohoes Fire Department will contact you with details.
Consent
I have read and agree to the terms of the Disclosure statement below.
The Cohoes Fire Department Local 97 coordinates its Holiday Assistance Program with other community agencies in an effort to meet the needs of the maximum number of families. By checking the consent box you give the Cohoes Fire Department Local 97 permission to share your application request with other assisting community agencies. Submitting this form does not guarantee assistance. If you are eligible for assistance you will be notified by phone.
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