2021 Love Out Loud Family Application - DePoy Ministries International

Please complete the following form to be considered in this year’s Love Out Loud Christmas Care Outreach.
Our goal is to notify all eligible families no later than December 12 on how to receive your Gift Cards from DePoy Ministries.
(Submission of this form in no way obligates DePoy Ministries to provide any service)

APPLICATION DEADLINE: December 3, 2021

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Love Out Loud Family Application

Date*
Date Format: MM slash DD slash YYYY
First Name*
Last Name*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Cell Phone*
Email*
Number of Children 17yrs and under*
Please list name of each child and age (17yrs and under)*
May we use your first name and/or photo(s) in our publications and on our website?*
How did you hear about Love Out Loud?*
Consent*
I agree
By submitting this form, I verify that I am not signed up with Community Care or any other assistance program for the holidays. “Love Out Loud” is an outreach ministry of DMI that strives to share the love of Jesus in a very tangible way that builds people up, protects their dignity, and empowers them for the future. Distribution day to be announced.