Christmas Family Adoption Application Form

Christmas Family Adoption Application 2024

Goodrich Foundation Resource Center & Girl FIx Your Crown Foundation will be adopting families for Christmas. Please fill out the form carefully for registration. please be advised that we will announce the adopted families at our Christmas Gala on Dec 22, 2024. You will receive email on event details. Deadline to apply is October 1st, 2024
Head of Household*

First NameMiddle NameLast Name
Date of Birth*

MonthDayYear
MM-DD-YYYY
Gender*

MaleFemale
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email:*

Confirmation Emailexample@example.com
Phone Number*
Please enter a valid phone number.
Number of people in your home:
Type number
Adults and Children over 12 in Home
1st Name (not head of household):

First NameLast Name
Date of Birth

MonthDayYear
Date
Relationship to you:
Type spouse, partner, parent, child, or other
2nd Name:

First NameLast Name
Date of Birth

MonthDayYear
Date
Relationship to you:
Type spouse, partner, parent, child, or other
3rd Name:

First NameLast Name
Date of Birth

MonthDayYear
Date
Relationship to you:
Type spouse, partner, parent, child, or other
4th Name:

First NameLast Name
Date of Birth

MonthDayYear
Date
Relationship to you:
Type spouse, partner, parent, child, or other
Children in Home (12 and under)

Fill out information for each child in your home
First Child: Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Age:*
Boy or Girl?*
Type Boy or Girl
Wish #1:
Type First Wish
Wish #2:
Type Second Wish
Wish #3:
Type Third Wish
Clothing Size (please indicate if it is children's size or adult size):
Type Size
Shoe Size (please indicate if it is children's size or adult size):
Type Size
2nd Child: Name

First NameLast Name
Date of Birth

MonthDayYear
Date
Age:
Boy or Girl?
Type Boy or Girl
Wish #1:
Type First Wish
Wish #2:
Type Second Wish
Wish #3:
Type Third Wish
Clothing Size (please indicate if it is children's size or adult size):
Type Clothing Size
Shoe Size (please indicate if it is children's size or adult size):
Type Shoe Size
3rd Child: Name

First NameLast Name
Date of Birth

MonthDayYear
Date
Age:
Boy or Girl?
Type Boy or Girl
Wish #1:
Type First Wish
Wish #2:
Type Second Wish
Wish #3:
Type Third Wish
Clothing Size (please indicate if it is children's size or adult size):
Type Clothing Size
Shoe Size (please indicate if it is children's size or adult size):
Type Shoe Size
4th Child: Name

First NameLast Name
Date of Birth

MonthDayYear
Date
Age:
Boy or Girl?
Type Boy or Girl
Wish #1:
Type First Wish
Wish #2:
Type Second Wish
Wish #3:
Type Third Wish
Clothing Size (please indicate if it is children's size or adult size):
Type Clothing Size
Shoe Size (please indicate if it is children's size or adult size):
Type Shoe Size
5th Child: Name

First NameLast Name
Date of Birth

MonthDayYear
Date
Age:
Boy or Girl?
Type Boy or Girl
Wish #1:
Type First Wish
Wish #2:
Type Second Wish
Wish #3:
Type Third Wish
Clothing Size (please indicate if it is children's size or adult size):
Type Clothing Size
Shoe Size (please indicate if it is children's size or adult size):
Type Shoe Size
6th Child: Name

First NameLast Name
Date of Birth

MonthDayYear
Date
Age:
Boy or Girl?
Type Boy or Girl
Wish #1:
Type First Wish
Wish #2:
Type Second Wish
Wish #3:
Type Third Wish
Clothing Size (please indicate if it is children's size or adult size):
Type Clothing Size
Shoe Size (please indicate if it is children's size or adult size):
Type Shoe Size
Have you previously submitted copies of all ID's for those in your family. If not, you may be asked to do so before your application can be processed.*

I have already submitted copiesI'm not sure if I have. Can you call me and let me know?I have not submitted copies. Upload information belowOther
Upload copies of IDs and income

Cancelof
Will you be available to attend the Christmas Gala on Dec 22, 2024?*
Do you need assistance for any of the following listed ? (this has no effect on your application)*
Would you like to be on our email list for future events ? YesNo
Would you like information in the spring on sending your child to a summer camp in the summer? YesNo
Tell us why your family should be adopted for Christmas?
Type your story here
Should be Empty:

Christmas Family Adoption Application 2024

Adults and Children over 12 in Home

Children in Home (12 and under)