Helping Families for Christmas 2012 Form

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If you are experiencing financial difficulties we would like to Help you this Christmas.

You will have until Saturday, December 8th at 5pm to submit this form. Once we have reviewed all of the submissions, we will choose the winner(s) and notify you via email. You will need to respond the email confirming your mailing address. Once confirmed, we will make the official announcement.

*PLEASE CHECK YOUR EMAIL on Monday, 12/10/11 so that we can confirm your address and info. and the cards can be mailed out to you as quickly as possible.

Full Name *

*of 1 of the family members receiving it

Valid Email Address *

*of family receiving it so we can contact them

City/State *

Tell us about your family *

# of family members, ages

Tell us your story / Why Do You Need Help This Christmas? *

*in 125 words or less

Prayer Requests -NOT MANDATORY

This will not be shared

Please read all of the details and check off each one once you have read them * *

*We want to be sure we are all on the same page :-)

You have until Saturday, 12/8 at 5pm to submit your info. to be considered

If selected, you will be notified by Email and must respond to confirm with your mailing address

Each submission will be reviewed but the # of families we are able to help will depend on the donations we receive

Required

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