J Town Bingo

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Santa’s Toy Chest Application:

Please complete ALL information and return in person by *Nov. 20, 2020.

No late applications accepted!

Please bring in the following when turning in application:

1. Valid Florida state issued ID or Driver’s License

2. Valid Proof of Residence – Tax Bill, Lease, Voter’s Registration card are acceptable

3. Valid current utility bill

4. Proof of Income

5. Birth Certificates for any child ages 1 thru 12 in home.

*Turn in times are Monday, Tuesday, Thursday & Friday from 2pm – 6pm

Parent/Guardian Name: _____________________________________________________________

Parent/Guardian Address: ___________________________________________________________


Parent/Guardian Phone: Home __________________ Cell__________________________________

(We must be able to contact you if application is accepted.)

Total # in Household_________

Names of those aged 1 – 12 in Home:

NameAgeM/FBirth Certificate





Employment and Income

Employer: ______________________________

Phone #: _______________________________

Net pay total for last month: ________________

*(must provide at least 2 pay stubs within 30 days prior)

Employer: ______________________________

Phone #: _______________________________

Net pay total for last month: _______________

*(must provide at least 2 pay stubs within 30 days prior)

Anyone in home active_________ or retired military___________?

Do you or anyone in the home receive any other assistance? ________

*(please provide statement/form from any agency with amount that you or anyone in home receive)

If yes, please list below:

1) From: ______________________

Amount: ____________________

2) From: ______________________

Bovada blackjack reddit. Amount: ____________________

3) From: _____________________

Amount: ____________________

If approved, preferred pick-up date and time (please check one provided)

Monday 12/14 3pm - 6pm ______

Tuesday 12/15 1pm - 4pm ______

*All information provided above must have documents to verify.

Signed: ___________________________ Date: ________________

Pick-up signature ____________________________________ Date _________________________________


MCC received (date): _____________ by (name): _________________________________________

MCC copies rec’d and verified by: _____________________________________________________

Approved: _____________ Not approved (reason): ______________________________________

Applicant called by: ___________________ Pick-up day/time: _______________________________

Pick-up signature ________________________________

Thu - Sun:10:00 AM - 11:00 PM
Thank You for visiting Our Website. Our goal is to give You, Our Valued Customers, the best service possible!
We are conveniently located on the SouthWest corner of Santa Barbara Boulevard & Veteran's Parkway, in the TOWERS II PLAZA. The same plaza as 'Five Guys Burgers & Fries'. A GOOGLE MAP IS AT THE BOTTOM OF THIS PAGE.
You can reach us at 239.772.4646 (239.77.BINGO). We are here 7 days a week, starting at 10 A.M., to answer your questions. You can also stop by, follow us on 'Facebook'@ Uptown-Bingo-of-Cape-Coral (click the fb logo above), or you can contact us at our e-mail address: office@uptownbingo.org
For your convenience, we offer both smoking and non smoking rooms. In either room you can purchase your pack, play BINGO, or play one of our great arcade games. Our Snack Bar is located in the non smoking room as well.
If you are not familiar with BINGO, we offer FREE BINGO every Saturday & Sunday @ 3:30!!! Our FREE BINGO sessions are a great way to meet us, make some new friends, and WIN MONEY too!!!
Thursday - Sunday starting at 6:30PM.
We are open for machine play only on

A listing of our daily events & monthly specials is available on our 'Events' page.
Thanks again for visiting our site. Have a look around and let us know what you think. We hope to see you soon!!!

J Town Bingo Schedule

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