Form Center

2. Crandall Christmas Stocking for Seniors

4. 
5. 

7.  

   The Crandall Stocking for Seniors provides Christmas cheer for our Senior Citizens that are 65 or older & has the City of Crandall as their Utility Service Provider.

    

   
   

   Please complete this form in its entirety and return to Crandall City Hall no later than Friday, December 1, 

   
   

   If you need to return this form before/after business hours, please place the form at the City Hall night drop located at the front door slot.  Address for City Hall is 110 S. Main Street, Crandall.

9. Name of Nominee
11. Street Address of Nominee
12. PO Box
14. City
15. State
16. Zip Code
18. Male/Female
19. Age

21.  

    I hereby authorize the Crandall Stocking for Seniors to verify this application for stocking for Seniors.

23. Signature

25. By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date. 

27. I Agree
Leave This Blank:


29. Submit

* indicates a required field