Seasonal Assistance Application

Seasonal Assistance Application
Dear Mansfield Resident/Family,

The Mansfield Human Services department recognizes all holidays that are celebrated throughout the year through our seasonal assistance application. We recognize how stressful this time can be for families in need and we want you to know we are here to help make things easier.

The seasonal assistance program has been revitalized with the understanding that many of our families celebrate various traditions over the coming months. This year we will be matching each family with a sponsor to provide gifts and other supports for the holidays. If a family is not matched with a sponsor, gift cards and/or gifts will be provided.

Resident households must be under 60% of the state AMI to qualify. Applicants must provide documentation showing all sources of income for all persons domiciled in the household.
Please completely fill out by Friday, November 14, 2025. Unfortunately, we will not be able to process or guarantee applications received after this date.

The Seasonal Assistance Program is for children 18 years of age and under. Families will be matched with a sponsor to provide gifts and other supports. If a family is not matched with a sponsor, gift cards and gift will be provided.

*Gift cards amounts will vary depending on the number of participants and donations.
Household Information
Name of applicant*
Date of Birth*

MonthDayYear
Date
Address*
Email: please provide an email address that you check regularly*
example@example.com
Preferred Phone*
Format: (000) 000-0000.

Please provide Information an all Adults (19+) living in the Household:*

Please provide information on all Children (18 and under) living in the Household:*

Seasonal Meal Baskets:
November Meal Basket (sides only based on funding)December Meal Basket (sides only based on funding)None
Any dietary requirements?
PLEASE CHECK ONE OF THE FOLLOWING
I/my household is currently on the Town of Mansfield Fee Reduction program and qualify for the Seasonal Assistance Program with no further documentation neededI/my household meets the residency and income guidelines eligibility outlined in the attached letter. I have attached the last 4 weeks of income verification (SSI statement, pay stubs, etc) for all income earners in the household.
Household’s current annual gross income from all sources is:
File Upload: Please provide 4 weeks of income if applicable.

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Giving Wish List
Please provide child's age, gender, clothing size, shoe size, favorite color and favorite character. Please tell us about your child's interest, things they are really hoping for, things that they love, and things that they need.

Please remember that this wish list will be given to a sponsor. Please provide as much information as possible to assist the sponsor in supporting your child.
Child 1 Initials: *
Child 1 Wish List: *
Child 2 Initials:
Child 2 Wish List:

Please provide child's age, gender, clothing size, shoe size, favorite color and favorite character. Please tell us about your child's interest, things they are really hoping for, things that they love, and things that they need.

Please remember that this wish list will be given to a sponsor. Please provide as much information as possible to assist the sponsor in supporting your child.
Child 3 Initials:
Child 3 Wish List:
Child 4 Initials:
Child 4 Wish List:

Please provide child's age, gender, clothing size, shoe size, favorite color and favorite character. Please tell us about your child's interest, things they are really hoping for, things that they love, and things that they need.

Please remember that this wish list will be given to a sponsor. Please provide as much information as possible to assist the sponsor in supporting your child.
Child 5 Initials:
Child 5 Wish List:
Child 6 Wish List:
Child 6 Wish List:

Please provide child's age, gender, clothing size, shoe size, favorite color and favorite character. Please tell us about your child's interest, things they are really hoping for, things that they love, and things that they need.

Please remember that this wish list will be given to a sponsor. Please provide as much information as possible to assist the sponsor in supporting your child.
Child 7 Wish List:
Child 7 Wish List:
Child 8 Wish List:
Child 8 Wish List:

Please provide child's age, gender, clothing size, shoe size, favorite color and favorite character. Please tell us about your child's interest, things they are really hoping for, things that they love, and things that they need.