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Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Are you receiving help from any other organizations for Christmas?
Is there anything special that would make this Christmas easier for your family?
Do you have transportation if gifts are pickup only ?
How many children do you need help with Christmas for?
What are their name(s) & ages?
List 3 References we can contact
We can not help everyone unfortantly but we will start responding October 1st via e-mail or text if you have been chosen to collect your children(s) wish list items for Christmas.
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