Holiday Adoption Application
The DCWMHC Prevention Program is organizing a Holiday Gift Drive to support low-income families in our community. If your family would like to be considered for adoption this holiday season, please complete the form below. The deadline to apply is December 8, 2025.
Parent/Guardian Name:
*
First Name
Last Name
Parent/Guardian Information:
*
Street Address
City/State
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Phone Number
Please enter a valid phone number.
Email
*
example@example.com
Are you currently residing on the Spokane Reservation or are the child(ren) Spokane Tribal Members?
*
Please Select
Yes, residing on Reservation
Yes, Tribal Member Child/Children
No
By selecting this, I am committing to picking up the gifts from the HHS building, in Wellpinit, when they are ready.
*
I agree
Would you prefer presents pre-wrapped?
*
Please Select
Yes
No
Number of children in your family (ages 0-17)
*
Please Select
1
2
3
4
5
6
7
8
9
10+
Child Information
*
Child Information
Child's First Name
Child's Age
Please Select
Gender
Please Select
Clothing Sizes
Favorite Color
Favorite Characters / Shows / Movies
Favorite Activities / Hobbies
Need Item(s)
Wish List
Child Information
Child's First Name
Child's Age
Please Select
Gender
Please Select
Clothing Sizes
Favorite Color
Favorite Characters / Shows / Movies
Favorite Activities / Hobbies
Need Item(s)
Wish List
Child Information
Child's First Name
Child's Age
Please Select
Gender
Please Select
Clothing Sizes
Favorite Color
Favorite Characters / Shows / Movies
Favorite Activities / Hobbies
Need Item(s)
Wish List
Child Information
Child's First Name
Child's Age
Please Select
Gender
Please Select
Clothing Sizes
Favorite Color
Favorite Characters / Shows / Movies
Favorite Activities / Hobbies
Need Item(s)
Wish List
Child Information
Child's First Name
Child's Age
Please Select
Gender
Please Select
Clothing Sizes
Favorite Color
Favorite Characters / Shows / Movies
Favorite Activities / Hobbies
Need Item(s)
Wish List
Child Information
Child's First Name
Child's Age
Please Select
Gender
Please Select
Clothing Sizes
Favorite Color
Favorite Characters / Shows / Movies
Favorite Activities / Hobbies
Need Item(s)
Wish List
Child Information
Child's First Name
Child's Age
Please Select
Gender
Please Select
Clothing Sizes
Favorite Color
Favorite Characters / Shows / Movies
Favorite Activities / Hobbies
Need Item(s)
Wish List
Child Information
Child's First Name
Child's Age
Please Select
Gender
Please Select
Clothing Sizes
Favorite Color
Favorite Characters / Shows / Movies
Favorite Activities / Hobbies
Need Item(s)
Wish List
Child Information
Child's First Name
Child's Age
Please Select
Gender
Please Select
Clothing Sizes
Favorite Color
Favorite Characters / Shows / Movies
Favorite Activities / Hobbies
Need Item(s)
Wish List
Child Information
Child's First Name
Child's Age
Please Select
Gender
Please Select
Clothing Sizes
Favorite Color
Favorite Characters / Shows / Movies
Favorite Activities / Hobbies
Need Item(s)
Wish List
Submit
Should be Empty: