Holiday Clearing House 2025

Deadline is 3PM on October 3, 2025 or until capacity of 525 approved families is reached.

You must be a Delaware County resident with children permanently residing in the home. This completed form and all required identification must be presented before application is accepted.

REQUIRED IDENTIFICATION AND PAPERWORK INCLUDE:

This completed application
Picture ID for head of household
Picture ID for each senior in household
Form of ID for each child applicant
- Examples for children: school ID, current shot record, medical card, passport or a court document

GENERAL INFORMATION

First Name *

Last Name *

Phone *

Email *

Address 1 *

Address 2

City *

State *

Zip *

Last four digits of SSN *

RESIDING IN HOME

Number of Adults *

Household Income *

Is anyone in the home over 62 years of age? *
Yes
No

Number of Children Residing in Home *

SPECIAL ACCOMODATIONS

Please note any special accommodations for a disability needed for the adult picking up at the clearing house.

Will an interpreter be needed? *
Yes
No

Language needed *

CHILD INFORMATION

Please fill out all fields in this section for each qualifying child.

You will be asked to upload the supporting documentation for yourself, each senior, and each child next.

Holiday Clearing House 2025

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People In Need of Delaware County Ohio, Inc.