IVDSA Holiday Meal Kits
This has been a tough year for us all, but more so for our special needs families. IVDSA is proud to be able to offer a little help this Holiday season. If you would like to receive a Holiday Kit, please fill out this form. (PICK-UP 12/19 between 11-2pm)
**Please note that not all items selected may be available. There is no guarantee  on selected items** PLEASE ONLY SUBMIT 1 FORM
Sign in to Google to save your progress. Learn more
Email *
Full Name *
Cell number *
Family size
Meal preference *
Do you need pantry staples? *
Do you need diapers & wipes? (If so what size)
Do you need household cleaning supplies? *
Do you need toiletries (toothbrush, toothpaste, shampoo etc)?   *
Ages, genders and sizes of children in the family
Comments
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms