Jurupa Valley Adopt a Family Holiday Giving Program Applications


All online applications will be closed at midnight on November 30th, 2018.

All printed applications that are mailed in must be postmarked on or before November 30th, 2018.

All applications turned into the Jurupa Valley City Hall must be received by close of business on November 30th, 2018.

Due to the number of applications received every year, we are unable to extend the deadlines in order to ensure fair consideration for all applicants.



Maximum household gross income for two person households is $24,000 per year, for three members it is $28,200 and for four person households it is $34,000. For every person above four in the household, the maximum rises by $5,800. Applicants for the program will need to present proof of income in the form of tax returns, pay stubs or government benefits statements for all adults living in the house.

Applicants must:

> Complete the entire application and sign it

> Be willing to participate in the pre-event screening

> Have children home during delivery

> Provide a place within their home for Santa to make contact with the children

> Not be participating in any additional programs that provide similar support

> Be willing to be photographed or have video taken of all parties for use in future marketing

> Provide proof of residency (Identification Card, Driver’s License or Utility Bill)

> Provide proof of income if requested (Payroll stubs, Previous year W-2)


Where to turn in or mail your application:

Jurupa Valley Adopt a Family Holiday Program

P.O. Box 3697

Jurupa Valley, CA 92519


Jurupa Valley City Hall

8930 Limonite Ave

Jurupa Valley, CA 92509

Business Hours: Mon-Fri 8am-5pm



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