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Holiday Program Sponsor Form

  1. Select the assistance you are providing - check ALL that apply:

    Please understand that once we receive your sponsor form we accept it as your commitment to help the individual or family with the resources you have selected.

  2. Thanksgiving Assistance:

  3. Enter a delivery time between 2pm-6pm.
    Delivery address: 85 Bells Hill Road, Stafford, VA 22554

  4. Sponsor preference:

    You may chose to adopt an entire family, individual seniors, adults or both.

  5. Do you want to adopt...

  6. Individual(s) Ages:

  7. Christmas Assistance:

  8. Enter a delivery time between 2pm-6pm.
    Delivery address: 85 Bells Hill Road, Stafford, VA 22554

  9. Sponsor preference:

    You may choose to provide food, gifts or both for entire family or individual seniors/adults or children.

  10. Do you want to adopt...

  11. *Leave blank if no preference.

  12. *Meal Only

  13. *Leave blank if no preference.

  14. Disclaimer:

    Please understand that once we receive your sponsor form we accept it as your commitment to help the individual or family with the resources you have selected.

    Checks payable to Stafford Social Services. Please write "Holiday Program - Undesignated Time" in the memo. Mail to Stafford Social Services, PO Box 7, Stafford, VA 22554.

    A confirmation page will display after you submit this form repeating this information.

  15. Leave This Blank:

  16. This field is not part of the form submission.