DEC. 2025 HOLIDAY BOX PICK UP REGISTRATION
LIMITED TO 100 FAMILIES
Brought to you by Prosperity Employment Outreach, Midland Baptist Crisis Center, and other community businesses who care.
PICK UP IS AT MIDLAND BAPTIST CRISIS CENTER, 806 S. BAIRD ST DECEMBER 19, 2025 FROM 11 A.M. - 1 P.M.
Please Bring your Identification.
Name
*
First Name
Last Name
Email Address
example@example.com
Contact Number
*
-
Area Code
Phone Number
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
CODE: (Call your referring agency if you do not have a code).
*
Submit
Should be Empty: