Help-a-Family Donor Form
Help-a-Family was born from the idea of Adopt-a-Family because we are aware that patients and families don't only struggle during the holiday season. Referrals come from the social workers at St. John's and are matched with a donor to help patients with anything from food insecurity to purchasing household items.

If you are interested in assisting a family or families in need throughout the year, please fill out the form below. 

If you have any questions, please contact Ceallaigh Watts, Development Coordinator at cwatts@ehs.org or 718.869.8058, thank you!!!
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Email *
Contact Person's First Name: *
Contact Person's Last Name: *
Will you be participating as an individual or as an organization/congregation? *
Name of Organization/Congregation (If Applicable)
Contact's Address, City, State, Zip Code *
Contact Person's Best Contact Phone # *
What size family would you be willing to help? Mark all that apply. *
Required
How many families do you think you or your organization/congregation can assist throughout the year? *
Required
Please write any additional comments or concerns here.
A copy of your responses will be emailed to the address you provided.
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