Christmas Cheer Recipient Questionnaire

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* 1. Please specify the needs of the person/family (check all that apply)

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* 2. Please provide YOUR name and contact email and phone number. (In case we require additional information about this application)

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* 3. Please let us know the the name(s) of the person/family in need.

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* 4. Please list GENDER, AGE and CLOTHING SIZE (if clothing is desired) of each member of the family

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* 5. Are there any known allergies/ items that should not be included for this person/family?

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* 6. What would this person/family benefit most from (check all that apply)?

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* 7. Please include name , address , phone number and any other relevant contact information for the recipient family

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