Holiday Program Sponsor Form

2. Community Partner/ Sponsor name*

3. Contact Person*

5. Mailing Address

7. City*

8. State*

9. Zip Code*

11. Email Address*

12. Best Phone Number to be Reached*

14. Below are options for Thanksgiving and Christmas. Choose one or both. Thank you for your support.

16. What would you like to donate: Thanksgiving Assistance*
    -- Select One --Food Basket and/or Food Gift CardMonetary DonationI am not sponsoring during Thanksgiving

    Please pick an option from the drop down menu.

17. Monetary Amount Donation:

19. Who would you like to gift to: Thanksgiving Assistance Recipient

    1. Family with children (1-17)
    2. Adult (18-59)
    3. Senior (60+)

21. Who: Size of family, individual and/or number of Seniors.

    What size family would you prefer making a basket for? 1-8 kids? A single-individual basket? If helping out one of our seniors, how many?

23. Where would you like to donate: Thanksgiving Assistance Delivery Method. Sponsor will:*
    -- Select One --Distribute to Client (Churches: Please leave date/time of distribution in comments below)Deliver to Client (This is arranged between Sponsor and Client)Deliver to DSS at Stafford Crossing Community Church on November 20th from 10:00 - 12:30 or 2:00 - 4:30 pmI am not sponsoring during Thanksgiving

    Please pick an option from the drop down menu.

25. Comments Regarding Distribution of Thanksgiving Assistance:

    Any other information you would like to provide or any questions you have for us.

27. * If you are looking for a unique way to transport the basket, a hamper is a solid "basket".

31. What would you like to donate: Christmas Assistance*
    -- Select One --Food Basket and/or Food Gift CardMonetary DonationFood and GiftsGiftsI am not sponsoring during Christmas

    Christmas assistance offers both a food and gifting option. Please pick an option from the drop down menu.

33. Who would you like to gift to: Christmas Assistance Recipient

    1. Child age (1-17)
    2. Adult age (18- 59)
    3. Senior age (60+)

    Please chose a group you would like to donate to for the Christmas holiday.

35. Who: Christmas Assistance Comments

    Give information regarding your potential recipient. What age? Sex? Family size? Number of seniors? A combination of any of these groups? This is the space to describe who you would like to gift. Please think about helping out someone unique this holiday season.

37. Where would you like to donate: Christmas Assistance Delivery Method *
    -- Select One --Sponsor Will Distribute to Client (Churches: Please leave date/time in the comment box below)Sponsor Will Deliver to Client (This is arranged between Sponsor and Client)Sponsor Will Deliver to DSS at Stafford Crossing Community Church on WEDNESDAY December 11th from 10:00- 12:30 pm OR 2:00 - 4:30 pmI am not sponsoring during Christmas

    Please pick a delivery option from the drop down menu.

39. Comments Regarding Distribution of Christmas Assistance:

    Comments, questions, ideas... etc.

Leave This Blank:


40. 1. Receive an email copy of this form.
41. Email address

    This field is not part of the form submission.

42. Submit Submit and Print

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