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Programs
Camp Cartwheel
Project A.R.K.
Education Services
The Caring Place
Orion Grant Fund
Fundraising
Classes/Groups
About Us
Volunteer
Contact
Camp Cartwheel
Project A.R.K.
Education Services
The Caring Place
Orion Grant Fund
Menu
Camp Cartwheel
Project A.R.K.
Education Services
The Caring Place
Orion Grant Fund
702.735.8434
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702.735.8434
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CHRISTMAS LIST - HOLIDAY ADOPT A FAMILY
Email
(Required)
Phone
(Required)
Diagnosed child's name
(Required)
Diagnosed child's gender
(Required)
All family members' names
(Required)
Note: All members of the immediate family including parents, siblings, and other relatives who reside in the home with the diagnosed child full-time. Use the '+' button to add a row for each entry.
Name
Relation
Age
Gender
Add
Remove
Clothing
(Required)
Note: Please list out all needed items for children living in the home. Make sure to be specific regarding size/color/style and who it is for. Use the '+' button to add a row for each entry.
Who is this for?
Item (ex. Jacket)
Size/Color/Style or other relevant info
Add
Remove
Gift cards
Only 2 per child allowed and please keep in mind that these cannot make up your TOTAL list. Please be specific as to which store you prefer and for whom the gift card is intended. Remember, the gift card(s) cannot exceed $500 per child. For example: Molly, Wal-Mart. Use the '+' button to add a row for each entry.
Who is this for?
Store (please be specific)
Add
Remove
Toys, games, books
Who is this for?
Item (please be specific)
Add
Remove
Other list items
Other items not listed. For example: Manicure gift card, spa day, massage, tickets to a concert venue, haircut and color. Please list names of the child/children requesting/receiving this item. Please be place/location specific.
Amazon Wishlist
Please create this on Amazon and include the link to the wish list for the donor
HIPPA & Information Sharing Consent
(Required)
NVCCF complies with the HIPPA act of 1996 in that we will ensure your privacy and protection during this process. Please know that adopters are also expected to keep private any information shared with them regarding the families we serve. I agree to whatever information shared will be kept confidential and there will be some information shared with the adopter.
I give permission for NVCCF to share information that is necessary
Anonymous Adopter Consent
If your adopter chooses to remain anonymous , then you will need to pick up the items at the NVCCF office. Please note that all items will need to be picked up no later than December 13 at 3 p.m. Do you understand this option?
I agree
Please Read!
(Required)
Each family who has been selected for the Adopt-A-Family program MUST COMPLETE THIS FORM IN ITS ENTIRETY in order to participate, ALL QUESTIONS MUST BE ANSWERED so that we may fulfill list items. Please be aware that the list contains requests only and may not be able to be fulfilled in its entirety. GIFT CARDS MAY NOT EXCEED $500.00 TOTAL PER CHILD.
I agree
Donation Form
First Name
*
Last Name
*
Email
*
Phone
Program
*
General Fund
Camp Cartwheel
Project A.R.K.
Education Services
The Caring Place
Orion Grant Fund
Select which NVCCF program you'd like to donate to.
Special designations and memos
Donation Amount
*
Minimum $5.00
Credit Card
*
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Supported Credit Cards: American Express, Discover, MasterCard, Visa
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