CARE for SANDY
Are you ready to "Adopt a Family"? Can you commit to purchasing at least one framed, restored print for a registered CARE for Sandy family? Yay, you! Please complete this registration form to get started.
* Required
TITLE
*
Choose
Mr.
Ms.
Mrs.
LAST NAME
*
Your answer
FIRST NAME
*
Your answer
EMAIL ADDRESS
*
Your answer
CONFIRM EMAIL ADDRESS
*
please repeat email
Your answer
MOBILE PHONE
*
Your answer
HOME PHONE
Your answer
BEST MODE OF CONTACT
*
Mobile phone, home phone or e-mail?
Your answer
COUNTRY
*
Your answer
STATE OR PROVINCE
*
Your answer
CITY
*
Your answer
ZIP OR COUNTRY CODE
*
Your answer
I PROMISE TO RESPECT MY ADOPTED FAMILY'S PRIVACY
*
By checking the "YES" box, I give my word that I will not publicize or distribute my family's name, mailing address, e-mail address, phone number(s) or photo(s) in any public form, electronic or printed. I promise to respect my family's privacy.
YES
I ACKNOWLEDGE THAT MY GIFT IS —NOT— TAX DEDUCTABLE
*
CARE for Sandy is not a formal not-for-profit, therefore any gifts must be given in-kind, and cannot be submitted to Uncle Sam come tax day.
YES
MY "ADOPTION" BUDGET
*
UP TO $15
UP TO $30
UP TO $50
UP TO $100
Other:
BEYOND AT LEAST ONE FRAMED PRINT, I MAY BE INTERESTED IN GIFTING THE FOLLOWING.
*
Check all (if any) that apply.
Duplicate print(s) of my framed, restored photo
Unframed prints of additional restored photos belonging to my adoptive family
All of my family's/families' prints, as restorations roll in throughout the year.
Photographic print(s) within a frame(s) — for my family or a new family
Photographic print(s) within an album(s)
Photographic print(s) within a calendar(s)
Gift Certificate in family's name
Other:
Required
I UNDERSTAND THAT I WILL BE RESPONSIBLE FOR ALL SHIPPING ARRANGEMENTS/COSTS ASSOCIATED WITH MY GIFT.
*
YES
Required
I AM INTERESTED IN ADOPTING THIS NUMBER OF FAMILIES
*
1
2
3-5
Other
I AM INTERESTED IN ADOPTING A FAMILY/FAMILIES FROM
*
Check all that apply.
BROOKLYN
LONG BEACH
LONG ISLAND
NEW JERSEY
ROCKAWAYS
STATEN ISLAND
DOESN'T MATTER
Other:
Required
I REPRESENT A BUSINESS AND CAN OFFER DISCOUNTS OF THIS VARIETY TO REGISTERED CARE FOR SANDY FAMILIES, RESTORATION VOLUNTEERS &/or YOUR ORGANIZATION IN GENERAL.
e.g. Discounted printing services, discounted frames/albums/scrapbooks. Please describe. Leave blank if not a business representative.
Your answer
I'M A RESTORATION VOLUNTEER. I'D LIKE TO HELP A FAMILY/FAMILIES THAT I'VE RESTORED IMAGES FOR.
Insert the file name of the image(s) you'd like to print and frame or buy an album for. Plus any other details we oughta know. (Leave blank if not a restoration volunteer.)
Your answer
YES, I WOULD LIKE TO BE THANKED BY NAME ON
careforsandy.org
's THANK YOU PAGE
Enter the name you wish to be credited with. Leave this question blank if no credit is desired.
Your answer
WHERE DID YOU HEAR ABOUT CARE for SANDY?
*
Your answer
ADDITIONAL COMMENTS?
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
