Y-C-Secret Santa Nomination Form
Nominate somebody else's kids to receive gifts.
This is our way to help you help someone else's family.
Sign in to Google to save your progress. Learn more
Email *
Your Full Name *
Your Phone Number *
Your Relationship to Recipient *
Do you want to remain anonymous? *
Recipient Parent's Full Name *
Their Phone Number *
Their Email
The Full Names of the Children, Their Gender, Their Age and What they Like *
If you don't know We can always ask the Head of Household
Desscribe why they deserve or need to be nominated for assistance with Christmas gifts. *
Agreement
By submitting this application you agree that you answered everything to the best of your knowledge and understand that purposely falsifying any information will cause this nomination to be rejected. You also understand the following:
To help the needy and not the greedy, these nominations are for people helping other people's family, we do check for authenticity as well. All the information provided will stay private, except the final question may be used by Youth Connect Club, with any names or specifics redacted.
Optionally, if you would like to make a donation to help out you can by clicking here.
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