Holiday Hope Donor Form

Name/Organization

Contact Name

First NameLast Name

Phone

Format: (000) 000-0000.

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Email

Please count me in! I would like to be involved in the following ways:

Please enter the number of families in each family size category you would like to sponsor:

Rows	Indicate the number of families for each
Small Family (consists of 2-3 people)
Medium Family (consists of 4-6 people)
Large Family (consists of 7+ people)

Do you have an age range preference for the children listed on the wish list? You're welcome to indicate one, though we can't guarantee it will be accommodated.

Your money will be used to buy gifts and food for families who were not matched for assistance, and for emergencies throughout the year.

Gift cards and certificates are particularly useful.

PLEASE MAKE CHECKS PAYABLE TO:

Child & Family Services Holiday Hope Project

SEND ALL CHECKS/GIFTS CARDS TO:

Child & Family Services

3057 Acushnet Ave

New Bedford, MA 02745