Holiday Help - Requesting Assistance (21-22)
DEADLINE NOVEMBER 5TH!!!!!!!!!
Only fill this out if you are requesting help this holiday season and would like your family to be adopted.
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Read below carefully!
All information you submit on this form will be given to the family, business or organization who adopts you. This is not an anonymous match. The family, business or organization will then contact you to arrange pick up or drop off of gifts. They may also contact you with additional questions about the needs and wants provided on the form.
Parent/Guardian Name *
Last name, First Name
Home Address *
Email Address (please be sure it is correct) *
Phone number(s) where you can be reached *
Please list home, work and cell as applicable. The family, business or organization adopting you will call these numbers to arrange pick up or drop off of gifts and if they have any additional questions.
By typing my name below I give my permission to give all information on this form to the family, business or organization adopting my family. I understand that this is just a request for help and there is a possibility our family will not be adopted. *
List the first and last names of all children in need of holiday help. This is the only place the children's names should be listed. *
Number of children in family needing gift assistance *
Number of adults living in the home *
Please check all schools your child(ren) attend *
Required
In the below section please DO NOT list any names of children. List each child's information under a separate letter. List - Gender, Age, Needs: clothing (include size/interests) & Wants: toys/interests
*We are asking families to spend about $50-75 per child they adopt, please keep requests reasonable and within this range.
PLEASE BE SPECIFIC! For example: Child A - female, 8, clothing: She is very girly and loves anything with glitter and rhinestones. Tshirts and Sweatshirts (8-10), jeans and leggings (10). She loves dresses (10-12). Gloves, scarf, hat, and pjs. Boots (2) and socks. Toys: she loves to dance, chapter books, arts and crafts, jewelry, nail polish, board games, American Girl Doll DVDs.
Child A *
Gender, Age, Needs: clothing (include size/interests), Wants: toys/interests BE SPECIFIC! Don't list name.
Child B
Gender, Age, Needs: clothing (include size/interests), Wants: toys/interests BE SPECIFIC! Don't list name.
Child C
Gender, Age, Needs: clothing (include size/interests), Wants: toys/interests BE SPECIFIC! Don't list name.
Child D
Gender, Age, Needs: clothing (include size/interests), Wants: toys/interests BE SPECIFIC! Don't list name.
Child E
Gender, Age, Needs: clothing (include size/interests), Wants: toys/interests BE SPECIFIC! Don't list name.
Child F
Gender, Age, Needs: clothing (include size/interests), Wants: toys/interests BE SPECIFIC! Don't list name.
Child G
Gender, Age, Needs: clothing (include size/interests), Wants: toys/interests BE SPECIFIC! Don't list name.
Child H
Gender, Age, Needs: clothing (include size/interests), Wants: toys/interests BE SPECIFIC! Don't list name.
Child I
Gender, Age, Needs: clothing (include size/interests), Wants: toys/interests BE SPECIFIC! Don't list name.
Child J
Gender, Age, Needs: clothing (include size/interests), Wants: toys/interests BE SPECIFIC! Don't list name.
List any other children here
Gender, Age, Needs: clothing (include size/interests), Wants: toys/interests BE SPECIFIC! Don't list name.
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