Cajun Santas Child Nomination
Here’s how it works:
• Anyone can nominate a child in need.
• You do not have to be related to the child.
• The child must be 13 years or younger by December 25, 2020.
• The child MUST reside in Avoyelles Parish, LA
• The nominator must agree to a phone interview as we move through the application process.
• Deadline to submit is November 20, 2020.
• The information you provide to us about the child is completely confidential.
• Not every child will be chosen.
• By submitting this nomination, you are acknowledging that you agree to these terms and conditions.
Your Email Address
Your Name and Phone Number *
Child's Name *
How do you know the child? *
Child's Gender *
Child's Birthday *
Child's Address *
Parent/Guardian Name *
Parent/Guardian Phone Number *
Child's Hobbies/Interests *
What is one gift that will make this child smile? *
Are there any other children 13 years of age or younger that also reside in the same home as this child? If so, please list the names below and FILL OUT A SEPARATE NOMINATION FORM for each child listed. *
In the section below, help us better understand why this child needs Cajun Santas' help this Christmas. Please be as thorough as possible, being sure to let us know if this child is in a crisis type situation at this time. Please also tell us about the day to day living situation of this child and any other information that you feel is pertinent for us to know. Please be very descriptive of the situation that you think makes the child deserving of the nomination. Details about the child are very important. This information is completely confidential and will not be shared outside of Cajun Santas. *
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy