2025 Operation Holiday Application

Unique ID
Submission Number
Are you a case manager filling this out for a client?*
- Yes
- No
Please select your location/organization from the dropdown menu below:*
Are you picking up items on your client's behalf?*
- Yes
- No
If yes, HumanKind will be in contact shortly to schedule your pick-up time for Tuesday, Dec. 17.
Are you filling this out at an application site?*
- Yes
- No
Please select your the application site from the dropdown menu below:*
Enter the application site:*

If you chose OTHER, please enter what site you are filling your application out at (Name and Address)
Please select ALL that you are requesting*
- Vouchers
- Food
- Pet Food
- Child's coat
- Toys
Pickup Date and Time:*
Operation Holiday will take place in a drive-through format. If you arrive PRIOR TO your selected pick-up time, you will be asked to come back for your correct time and date. No exceptions.
Name*
First Last
Email*
Date of Birth:*
MM slash DD slash YYYY
Gender:*
Address:*
Street Address Address Line 2 City State ZIP Code
Please abbreviate directions. No punctuation after.
Ex: North = N, South = S, etc.
Street names must be listed as abbreviations. No punctuation after.
Ex: Street = St, Road = Rd, Circle = Cir, Lane = Ln, Avenue = Ave, Court = Ct
Telephone/Message Number:*
Language Preference:
Race:
Do you have pets?
- No
- Yes
Dogs and/or Cats?*
- Dogs
- Cats
Please select all that apply
Spouse/Other Adults Living in the Household
Age 18 or older. You will NOT be able to edit this section after application submission, please include ALL adults in the household.

Adults in household

Name	Date of Birth:	Gender:	Actions

There are no Adults.

Only one application per household. Please add additional adults living in the same household in the “add adult” section above.

Children Living in the Household
Age 17 or younger. You will NOT be able to edit this section after application submission, please include ALL chidlren in the household.

Children in household

Name	Age	Gender:	Coat Size:	Coat Priority	Actions

There are no Children.

Income
Please enter your household's 2-month gross income; including any disability, social security, child support, etc.
2-month household income exceeds income eligibility.
2-month household income exceeds income eligibility.
2-month household income exceeds income eligibility.
2-month household income exceeds income eligibility.
2-month household income exceeds income eligibility.
2-month household income exceeds income eligibility.
2-month household income exceeds income eligibility.
2-month household income exceeds income eligibility.
2-month household income exceeds income eligibility.
2-month household income exceeds income eligibility.
2-month household income exceeds income eligibility.
2-month household income exceeds income eligibility.
2-month household income exceeds income eligibility.
2-month household income exceeds income eligibility.
2-Month Family Income:*
Income Source:*
Employer:
Proof of Income
Accepted file types: jpg, gif, png, pdf, Max. file size: 300 MB.
If you cannot upload proof of income at this time you will need to bring proof of income to distribution.
I understand that I must bring proof of income with me to distribution. I understand that by NOT doing so, I will not receive assistance.*
- I understand.
I understand that I must bring proof of income with me to distribution. I understand that by NOT doing so, I will not receive assistance.
Disclaimer*
I agree.
I certify that the information I have provided is true and correct. I am aware that failure to provide complete information or the completion of more than one application may be grounds for denial of assistance. I consent to the release of pertinent information contained on this form as necessary to concerned social services agencies, HumanKind Ministries, Salvation Army and vendors. I agree that HumanKind Ministries may use photographs of me with or without my name.

I understand that participation in the Operation Holiday distribution process involves a certain degree of risk. I have carefully considered the risk involved and hereby consent to participate and fully understand the risk associated with my participation. I understand that participation is entirely voluntary and requires participants to abide by applicable rules and standards of conduct. I knowingly and voluntarily release HumanKind Ministries, Inc., Wichita, the activity coordinators, officers and directors, all employees, volunteers, related parties, clients, or other organizations associated with the activity from any and all claims or liability arising out of this participation.
Hidden
Photo/Video Consent & Release*
I agree
I hereby grant HumanKind Ministries permission to use my likeness and my dependents' likeness in a photograph or video in any and all of its publications, including website and email marketing. I understand and agree that these materials will become the property of HumanKind Ministries and will not be returned. I hereby irrevocably authorize HumanKind Ministries to edit, alter, copy, exhibit, publish, or distribute photos or videos in which I appear for purposes of publicizing HumanKind Ministries' programs or for any other lawful purpose. In addition, I waive the right to inspect or approve the finished product, including written or electronic copy, wherein my likeness appears. I hereby hold harmless and release and discharge HumanKind Ministries from all claims, demands, and causes of action, which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf or on behalf of my estate have or may have because of this authorization.
Photo/Video Consent & Release*
- I agree
- I do not agree
I hereby grant HumanKind Ministries permission to use my likeness and my dependents' likeness in a photograph or video in any and all of its publications, including website and email marketing. I understand and agree that these materials will become the property of HumanKind Ministries and will not be returned. I hereby irrevocably authorize HumanKind Ministries to edit, alter, copy, exhibit, publish, or distribute photos or videos in which I appear for purposes of publicizing HumanKind Ministries' programs or for any other lawful purpose. In addition, I waive the right to inspect or approve the finished product, including written or electronic copy, wherein my likeness appears. I hereby hold harmless and release and discharge HumanKind Ministries from all claims, demands, and causes of action, which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf or on behalf of my estate have or may have because of this authorization.
Household total*
Hidden
Household Children*
Hidden
Household Adults*
Are you designating another adult to pick up your items for you?*
- Yes
- No
*Case Managers and Application Sites, please keep as 'No'*
Contact Information of Person Filling Out Application*

If you are filling out this form for someone else, please let us know how we can contact you in case we have any questions
Is the primary contact for this application different than the contact information provided above?*
- Yes
- No
*Case Managers and Application Sites, please keep as 'No'*
Designated Pickup Person*

If you are designating someone to pick up your items for you please put their name here. They will be required to show identification at pick up.
CAPTCHA
Please ensure all information above is accurate/complete to your knowledge. Once your application has been submitted, you CANNOT go back and add/alter information - to add/alter information, you will have to call HumanKind and complete a new application

2025 Operation Holiday Application (1)

Spouse/Other Adults Living in the Household

Children Living in the Household

Income

HumanKind Ministries