FORM IS NOW CLOSED.  We are hoping to help the 21 families who have already sent in forms but that should be the extent of what we can handle. THANK YOU and Merry Christmas!
Are you struggling and need help fulfilling your children's Christmas lists? Please fill out the form below.
Sign in to Google to save your progress. Learn more
What is your contact information (Name and Cell, please)? (THIS WILL BE KEPT CONFIDENTIAL)
How old is your child(ren)?
Please list a few things they want for Christmas that you have been unable to afford this year? 
Would you be able to pick up from the South Riding area tomorrow (Christmas Eve) if we are able to fulfill all or part of this Christmas wish?
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms