Hope For the Holidays Form

2024 Hope For The Holidays
Application Family Form

* Indicates required field

Mom's Name *

First

Last

Phone Number *

Email *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Are you an active mom with Shelter From the Rain? *

Yes, I attend support groups. Yes, I am in the mentorship program. No. Currently, I am not active in any programs.

How many support groups have you attended this year? *

Mom's Age *

Mom's Clothing Size *

Mom's Shoe Size *

Mom's Favorite Color *

Number of Children *

Children's Full Names, Ages, AND GENDER (Example: 1. John Doe, Age 4, Male.) *

Children's Clothing and Shoe Sizes (Example: 1. Jane Doe, 2T Clothing, Children's 2 size shoe) *

Family's Favorite Foods *

Household Needs (Example: Laundry Detergent, Toilet Paper, etc.) *

Christmas Wish List Items For Mom *

Christmas Wish List Items for the Children *

Additional Information *

Submit