Grant County Holiday Project Online Application

If you do not wish to fill out the application online, you may download the pdf application. Then mail your application

There are 5 steps to the online application. Fill out each section then click next.

Please fill in your email address to receive notification your application is accepted or denied.

DO NOT close your browser or use your browsers back button once you have proceeded to step 2. Please use the back button and cancel button provided.

* denotes a required field

You must be a resident of Grant County Wisconsin to receive this service
* First Name:		* Last Name:
* Address:		* City:	--SELECT-- ////////////loading list of cities from database. BagleyBeetownBloomingtonBlue RiverBoscobelCassvilleCuba CityDickeyvilleFennimoreGlen HavenHazel GreenKielerLancasterLivingstonMontfortMount HopeMuscodaPatch GrovePlattevillePotosiPrairie du ChienStitzerWoodman
* Phone:		Check if a member of your household is diabetic.   Check-I give permission to adopt my family to other organizations (confidential)
Email:		Confirm Email:
If you wish to have either a blanket or sheets select one.		Sheets   Blanket	Size: Select Size Twin Full Queen King

Grant County Holiday Project | Official Grant Co. Website | Admin