Holiday Form

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Holiday Support Interest Form

Please complete this form to be considered for receiving gifts and resources this holiday season.

First name

Last name

Code

Phone

City and State

What is your ethnicity or racial background? *

African Descent (Black, African American, Jamaican etc.)

Asian Descent

Europen Descent

LantinX

Native American

Pacific Islander

Other

Do not wish to disclose

Number of children receiving gifts

Please provide the names, ages, genders, clothing sizes, and any specific interests or preferences of your children. For example: John Doe, 4 years old, Male, Size 4T, enjoys art and science

What is your household income?

What is your household size

Would you be able to pick up gifts in Fontana, CA? *

Yes

Could you kindly share with us why you are in need of gifts this holiday season? Your response will help us understand and address your family's specific needs .

By attending our holiday event, do you consent to us taking photos and videos of you and your family and using them for our organization's promotional and educational purposes? *

Yes

Thanks for registering.

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