Holiday Kids Applications 2019
Email address *
Please check off that the recipient meets each of the following criteria. *
Required
Child's Full Name *
Your answer
Child's Age (As of 12/01/2019) *
Your answer
Child's Birthday (include year) *
MM
/
DD
/
YYYY
Gender Identity (of recipient)
Your answer
Full name of person filling out this form *
Your answer
Your relationship to the child *
Names of parents / guardians (all) *
Your answer
Names and ages of siblings *
Your answer
Diagnosis *
Your answer
Prognosis *
Your answer
If cancer or similar, are you... *
Date of diagnosis / onset of illness *
Your answer
What hospital(s) are you treated at? *
Your answer
Are treatment costs affecting your holiday plans? This will not affect the package, but we will reach out about other ways to help you financially <3 *
Recipient's Favorite Color(s) *
Your answer
Recipient's Hobbies *
Your answer
Recipient's Favorite TV Shows, Movies, Books, Games, Etc. *
Your answer
Recipient's Favorite characters and celebrities *
Your answer
Allergies or Sensitivities to FOOD *
Your answer
Allergies or Sensitivities to BEAUTY PRODUCTS *
Your answer
What winter holiday(s) does your family celebrate? *
Your answer
Social media usernames (of warrior) *
Your answer
Have you ever received a package from Invisible No More or Joy Packages? *
Do you agree to send photographic proof that you received the package? *
May we post your photos on our social media or website?
Full Name of Child (for mailing) *
Your answer
Street Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
If you are in the NYC/Northern New Jersey area, would you be interested in a hand delivery? *
Contact Info (IG username, email, etc) (of person filling out form) *
Your answer
How else can Invisible No More help you? *
Your answer
Anything else you'd like us to know? *
Your answer
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