Request for Assistance

Please complete the form below to request assistance for yourself or for someone else. Scituate Community Christmas support is available only to Scituate residents. Children are eligible up to their 18th birthday, unless the individual is disabled. All information provided is kept in strict confidence.

Please feel free to reach us anytime by email at

Applicant Information
Your Name *
Your Name
Please enter your full name.
If you belong to a church, non-profit, or other organization, please list the name below.
Family Information
Please enter the last name of the family for whom the assistance is being requested.
Head of Household *
Head of Household
Please enter the first and last name of the person who is the head of the household requesting assistance.
Head of Household Address *
Head of Household Address
Head of Household Phone
Head of Household Phone
Please list the names of any schools which children in this family attend.
Please describe the Head of Household's relationship with the children.
Is the Head of Household a Veteran? *
Has this family received support from Scituate Community Christmas in previous years?
Does the Head of Household have full custody of the children? *
What is the marital status for the Head of Household? *
Does the Head of Household receive child support? *
Select the Head of Household's living arrangements. *
Please check off any assistance programs that are already in effect. *
Are there pets in the family? *
Is there a need for school supplies? *
Is there a need for assistance with a Christmas Tree?
Family Members
For each member in the family, please include name, age, gender, size and interests.
Please check off the stores where gift cards would be most welcome.
Please indicate your preference on gifts pick up or delivery. *