CHRISTMAS LIST - HOLIDAY ADOPT A FAMILY

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
 
Needs List (Clothing)(Required)
Note: Please list out all needed items. 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
 
Needs List (Cleaning supplies or items)(Required)
Note: Please list out all needed cleaning supplies or items, such as mops, brooms, disinfecting wipes, vacuum, laundry detergent, etc.. Use the '+' button to add a row for each entry.
Item (please be brand specific)
Fragrance/Style
 
Needs List (Household items)(Required)
Note: Please list out all needed household items such as: decor, hair appliances, other small appliances, kitchen supplies, towels, pots and pans, sheets. Please be as specific as possible including size, style, color etc. Please also include person receiving the donation in this form for each item listed. Use the '+' button to add a row for each entry.
Who is this for?
Item (please be brand specific)
Size/Color/Style or other relevant info
 
Needs List (Toiletries)(Required)
Note: Please list out all needed toiletries such as: deodorant, shampoo, soap, toothbrush,etc. Please include preferred brand. Please also include person receiving the donation in this form for each item listed. Use the '+' button to add a row for each entry.
Who is this for?
Item (please be brand specific)
Size/Color/Style or other relevant info
 
Needs List (Furniture)(Required)
Note: Please list out all needed furniture, Christmas tree, beds/mattresses, couches, etc. Please list the person requesting/receiving the item. Use the '+' button to add a row for each entry.
Who is this for?
Item (please be brand specific)
Size/Color/Style or other relevant info
 
Needs List (Prescription items)(Required)
Note: Please list out all needed items such as glasses or contacts or other items that need to be filled. Use the '+' button to add a row for each entry.
Item (please be as specific as you can)
Size/Color/Style or other relevant info
 
Other need items not listed such as : Vehicle repair (please include make, model, year and what exactly needs to be repaired). Groceries (please be exact with brand and size such as :Bush's baked beans, small can) Christmas dinner items (please be exact and specific and note any food allergies if applicable).
Wants List (Gift cards)
Only 2 per person 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. For example: Molly, Wal-Mart. Use the '+' button to add a row for each entry.
Who is this for?
Store (please be specific)
 
Wants List (Toys, games, books)
Only 2 per person 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. For example: Molly, Wal-Mart. Use the '+' button to add a row for each entry.
Who is this for?
Item (please be specific)
 
Wants List (Perfume, cologne, jewelry)
Please be specific as to brand, style and size. Please list all names as to who will be receiving this item. Use the '+' button to add a row for each entry.
Who is this for?
Item (please be specific)
Size/Color/Style
 
Other want items (not NEED items) not listed. For example: Manicure gift card, spa day, massage, tickets to a concert venue, haircut and color. Please list names of the person/people requesting/receiving this item. Please be place/location specific.
Please create this on Amazon and include the link to the wish list for the donor
HIPPA & Information Sharing Consent(Required)
Anonymous Adopter Consent
Please Read!(Required)