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2023 Master Application – Shelter/Emergency

Application Use – Disclaimer

Clothe-A-Child Program 2023-2024

You must agree to the below Terms and Conditions in order to receive clothing services from Charity Newsies.

I have read the above Terms and Conditions of this application and agree that my family and the children to be listed on this application qualify for this program. *

Yes

No

Applicant does not qualify for this program

Parent / Guardian Information

Is this your first time receiving help from Charity Newsies? *

Yes

No

Parent/Guardian – First Name. Must match government issued ID. *

Name may only contain letters or spaces.

Parent/Guardian – Last Name. Must match government issued ID. *

Name may only contain letters or spaces.

Do you currently live in a homeless or emergency shelter? *

Yes

No

Name of Shelter *

Parent/Guardian – Address: Please do NOT use the # sign. *

City *

County *

Applicants and children MUST be residents of Franklin County

Invalid County message *

Zip Code *

Parent/Guardian – 10 Digit Phone Number (XXX) XXX-XXXX *

Parent/Guardian – Email Address *

Enter Email

Confirm Parent/Guardian – Email Address *

Confirm Email Address

Parent/Guardian – Birth Date mm/dd/yyyy *

Parent/Guardian – Last Four Digits of Social Security # or TFIN *

Marital Status *

Household Gross Monthly Income *

Additional Assistance – Check all that apply *

Housing Assistance (H)

SNAP (SP)

TANF (T)

Medicaid (M)

Health Start (H)

SSI (S)

Unemployment (U)

Other (O)

Choose not to provide (N)

Race – Check all that apply *

White (W)

Black or African American (BA)

American Indian or Alaska Native (AA)

Asian Indian (AI)

Chinese (C)

Filipino (F)

Japanese (J)

Korean (K)

Vietnamese (V)

Other Asian (OA)

Native Hawaiian or other Pacific Islander (NH)

Choose not to provide (OO)

Is anyone in your family of Hispanic origin? *

Yes

No

Choose not to answer

Child(ren) Information

schoolkids

Child – First Name. Must match school ID. *

Child – First Name. May only contain letters or spaces.

Child – Middle Name *

Child – Middle Name. May only contain letters or spaces.

Child – Last Name. Must Match School ID. *

Child – Last Name. May only contain letters or spaces.

Relationship to Child *

Relationship to Child

I attest that I have legal guardianship of the above named child and that they are actively living in my household. *

Yes

No

I attest that I have legal guardianship of this child and that they are actively living in my household.

Child – Birth Date mm/dd/yyyy *

Child – Birth Date mm/dd/yyyy

Child – Age *

Child – Age

Child – Last Four Digits of Social Security Number *

Child – Last 4 digits of SSN

Race – Check all that apply *

White (W)

Black or African American (BA)

American Indian or Alaska Native (AA)

Asian Indian (AI)

Chinese (C)

Filipino (F)

Japanese (J)

Korean (K)

Vietnamese (V)

Other Asian (OA)

Native Hawaiian or other Pacific Islander (NH)

Choose not to provide (OO)

Race – Check all that apply

Student ID

Student ID

Gender for Clothing *

Male

Female

Gender

Grade Level *

Grade Level

Name of School *

Name of School

Continue with this school choice (UV) *

Yes

No

Continue with this school choice

Continue with this school choice (SV) *

Yes

No

Continue with this school choice

Continue with this school choice (DNP) *

Yes

No

Continue with this school choice

Continue with this school choice (DC) *

Yes

No

Continue with this school choice

Continue with this school choice (ED) *

Yes

No

Continue with this school choice

Choose a different school

Grade Specific colors

White Shirt

Black Shirt

Purple Shirt

Red Shirt

Maroon Shirt

Hunter Green Shirt

Gray Shirt

Navy Shirt

Light Blue Shirt

Blue Shirt

Yellow Shirt

Any Color Polo Shirt

Khaki Pants

Black Pants

Navy Pants

Uniform Voucher Certificate

Shirt Voucher Certificate

Shirt is purchased from school

Dress Code

Dress Code

No Dress Code

No Dress Code

Whitehall School District

Shirt – Voucher Provided *

Shirt – Voucher Provided

Shirt – Required to purchase from school *

Shirt Required to purchase from school

Uniform – Voucher Provided *

Uniform – Voucher Provided

Shirts – Men & Boys Dress Code *

Shirt – Men & Boys Dress Code

Shirts – Men & Boys Everyday *

Shirt – Men & Boys Everyday

Shirt – Women & Girls Dress Code *

Shirt – Women & Girls Dress Code

Shirt – Women & Girls Everyday *

Shirt – Women & Girls Everyday

Pants – Men & Boys Dress Code *

Pants – Men & Boys Dress Code

Pants – Men & Boys Everyday *

Pants – Men & Boys Everyday

Pants – Women & Girls Everyday *

Pants – Women & Girls Everyday

Pants – Women & Girls Dress Code *

Pants – Women & Girls Dress Code

Coat Sizes – Men & Boys *

Coats – Men & Boy

Coats Sizes – Women & Girls *

Coats – Women & Girls

Hat & Gloves *

Hat & Gloves

Underwear – Men & Boys *

Underwear – Men & Boys

Undershirt – Men & Boy *

Undershirt – Men & Boys

Underwear – Women & Girls *

Underwear – Women & Girls

Undershirt – Women/Girl not available *

Undershirt – Women/Girl not available

Sock Size – Men/Boy *

Sock Size – Men & Boys

Sock Size – Women/Girl *

Sock Size – Women & Girl

Comments: 120 Characters or less

Feel free to share any information that may help us to provide your child the best possible fit. Limit 120 characters.

Add Child Remove Above Child

If you are human, leave this field blank.

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Contact us

T: 614-263-4300
F: 614-262-8810 info@charitynewsies.com
clothing@charitynewsies.com

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Office Headquarters

4300 Indianola Ave,
Columbus, OH 43214
HOURS: M-F 9:00 am – 12:30 pm

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