Back to Basics Angel Adoption Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Thank you for participating in the Back to Basics Angel Program!
The Back to Basics Angel Program relies heavily on participation and donations from the community.

We will provide Angel Tags with a child's information and the following instructions:

- Purchase NEW sneakers, socks, underwear & toy (and batteries, if needed for the toy)

- Wrap each gift and place in a gift bag.

- Remove the instructions and TAPE the Angel Tag to the outside of the gift bag, showing the child's information. (no staples on the bag please!)

Questions: 561-319-4277, info@BacktoBasicsInc.org

Gifts should be returned to our warehouse at:

2365 Vista Parkway, #19

West Palm Beach, FL 33411

Due date will depend on the Angel Tags that you receive.

Thank You!

Email *

Are you representing an organization to adopt multiple Angels or are you adopting Angels yourself? *

Adopting Angels for an Organization

Adopting Angels for myself

If your are adopting for an organization, please note Organization:

How many Angels would you like to adopt? *

How would you like to receive your Angel Tag(s)? *

Mail

First Name *

Last Name *

Address

City

State

Zip

Phone *

Comments or Questions?

A copy of your responses will be emailed to the address you provided.

Submit

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