Mitten State Santa Video Message
Please fill in the below information for your Personalized Video message
Email address *
Your Name *
Please enter First and Last name
Age of Child *
Which service would you like to receive *
For Video Factime messages, you will receive an email to set up the best time for your call.
Your Relationship w/ Child: *
Select only one
Child's Name *
Please enter First and Last Name, thank you!
Child's Favorite Activities *
You may list more then one
Child's School *
Child's Teacher *
First and Last Name
Please list your child's recent accomplishment *
You may list more then one
Something the child has done that you feel proud about *
You may list more then one
Areas of improvement you would like Santa to encourage *
Any other special information for Santa -
A copy of your responses will be emailed to the address you provided.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy