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Florida Easter Sign up 2026
Easter Baskets for kids ages 0-17 who have been directly affected by the drug epidemic. Children MUST be living with you in order to apply (unless you are currently in a Recovery or Sober Living home).
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Email
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Your email
Name (First and Last)
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Your answer
Address
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Your answer
City
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Your answer
County
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Brevard- North of Pineda
Brevard- South of Pineda
Flagler
Lake
Marion
Orange- East
Orange- West
Pasco
Seminole
Sumter
Volusia
Phone Number
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Your answer
HOW have your children been affected by the drug epidemic? (Please do not just answer yes)
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Your answer
Child 1 Name
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Your answer
Child 1 age
Your answer
Child 1 gender
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Boy
Girl
Child 2 Name
Your answer
Child 2 age
Your answer
Child 2 gender
Boy
Girl
Clear selection
Child 3 Name
Your answer
Child 3 age
Your answer
Child 3 gender
Boy
Girl
Clear selection
Child 4 Name
Your answer
Child 4 age
Your answer
Child 4 gender
Boy
Girl
Clear selection
Are you currently in a Recovery or Sober Living Home?
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Yes
No
If you are in a Recovery or Sober Living Home, which one?
Your answer
How did you hear about Project Noelle?
Your answer
Please let us know any allergies, etc
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A copy of your responses will be emailed to the address you provided.
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