CHILDREN NOT SERVED FORMNote: Photocopy, complete, and mail to Angel Tree,44180 Riverside Pkwy, Lansdowne, VA 20176 or fax to 1-877-281-4129.

Church/Organization Name: ____________________________________________________City, State, ZIP: ______________________________________________________________

Revised 5/2018

_________________________________________________ __________________________________________________Prisoner’s Name Application ID #

____________________________________________________________________________________________________Children’s Names

Please check the reason for not serving children this Christmas: unable to locate/no response from caregiver invalid age ineligible relationship not with caregiver court order against contact caregiver refusal (reason): ______________________________________________________________________

We notified the prisoner-parent that their children were not served by our church/organization and provided the reason: Yes No

_________________________________________________ __________________________________________________Prisoner’s Name Application ID #

____________________________________________________________________________________________________Children’s Names

Please check the reason for not serving children this Christmas: unable to locate/no response from caregiver invalid age ineligible relationship not with caregiver court order against contact caregiver refusal (reason): ______________________________________________________________________

We notified the prisoner-parent that their children were not served by our church/organization and provided the reason: Yes No

_________________________________________________ __________________________________________________Prisoner’s Name Application ID #

____________________________________________________________________________________________________Children’s Names

Please check the reason for not serving children this Christmas: unable to locate/no response from caregiver invalid age ineligible relationship not with caregiver court order against contact caregiver refusal (reason): ______________________________________________________________________

We notified the prisoner-parent that their children were not served by our church/organization and provided the reason: Yes No