JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Mother's Day Kit Drive
Thank you so much for volunteering to purchase items and assemble kits for vulnerable New York moms! We want all moms to feel special and loved this month with a small gift. Please fill out the information below to register for this opportunity.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Team Leader Full Name
*
Your answer
Team Name
Your answer
How many kits can you make?
*
1-15
15-30
30-50
50-70
70 or more
What items will be in your Mother's Day Kit?
*
Makeup
Nailpolish and Manicure Kits
Perfume and Lotion
Soap and Body Wash
Shampoo and Conditioner
Jewelry
Hairbrush and Comb
Hair Clips and Adornments
Socks
Reusable Water Bottles/Tumblers
$5-10 Gift Cards (Starbucks, Dunkin Donuts, etc.)
Required
Can you deliver these items or drop them off?
*
YES
NO
I can drop off in Downtown Manhattan, NYC.
I can drop off in Midtown East, Manhattan, NYC.
I can deliver to Staten Island, Manhattan or the Bronx.
I can deliver to the Lower Hudson Valley.
I can mail these items to your facility.
YES
NO
I can drop off in Downtown Manhattan, NYC.
I can drop off in Midtown East, Manhattan, NYC.
I can deliver to Staten Island, Manhattan or the Bronx.
I can deliver to the Lower Hudson Valley.
I can mail these items to your facility.
Contact info
Let's finalize some details! Who should we contact for further information?
Name
Your answer
Phone number
*
Your answer
Preferred contact method
*
Phone
Email
Required
Questions and comments
Your answer
A copy of your responses will be emailed to the address you provided.
Submit
Page 1 of 1
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
