Police Department Forms - Rochester, Illinois

Child's Name

Child's Age

Boy Girl

Parent's/Guardian Name

Phone

Address

Names/ Ages/ Relationship of everyone living in the house

Tell us about the child(ren) you nominated

Clothing Type and Size

Check all interest that apply:

Sports Fishing Music Dance Reading

Tell us about the family you nominated

This program is for families with financial hardship. Please describe the financial needs of the family and any ideas or suggestions for helping to meet their particular needs

Nomination for ELFs Recipient