Adopt-A-Senior Form for Senior
Use the form below to identify a senior who can be honored by having someone "adopt" them.

For every case of COVID in MD, respond with an act of love. Visit mountaincc.org/daretolove to see how you can get involved.
SENIOR INFORMATION
Name of Senior *
Your answer
School Senior Is Graduating From *
Your answer
Address for Delivery *
Your answer
Do you give us permission to share the address with the person "adopting" the senior? *
If you mark no, we cannot guarantee your senior will receive an adoption gift.
PERSON SUBMITTING INFORMATION
Name of Person Submitting *
Your answer
Email for Person Submitting *
There will be an email sent once the senior has been "adopted."
Your answer
Phone Number for Person Submitting *
This is used only if there is incorrect information or difficulties in the delivery process. Please have this NOT be a seniors number if possible.
Your answer
PERSONALIZED INFORMATION
To help the person "adopting" your senior, what are a few things that they are interested in? *
Your answer
What kind of candy or food do they like?
Your answer
Any food allergies to be aware of? *
Your answer
HAVING TROUBLE FILLING OUT THIS FORM?
Contact someone from the Mountain Students Team for assistance. You can reach them at Students@MountainCC.org.
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