CONTACT INFORMATION

What name would you like us to use today?

What’s the best phone number for updates or future resources?

Do you have an email you’d like to share?

How would you prefer we reach you if needed?

Select contact preference

HOUSEHOLD INFORMATION

To make sure we have enough for everyone, how many people are in your household?

What ages are represented in your home?

Does your household include any children or seniors?

Select age group

CHILDREN INFORMATION

Do any children have special circumstances we should be aware of? (Optional)

TOY PREFERENCES

What types of toys would be most helpful for your children? (Optional)

SUPPORT NEEDED

OPTIONAL DEMOGRAPHICS

These optional questions help us qualify for grants so we can keep offering free support events like this.

Select employment status
Are you part of a veteran?
Are you part of a single-parent household?

CONSENT + FOLLOW-UP

Consent to safety & food availability
Yes/No

Would you like to receive updates about future giveaways or support events?

Would you like to receive updates about future giveaways and support events?

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