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SUBMIT
Adopt-a-Family Donation
My Name
*
My Phone Number
*
My Email Address
*
Enter Email
Confirm Email
Is your small group contributing this donation?
*
Yes
No
My small group info (or leader names):
This commitment will be in the form of (check all that apply):
*
A Monetary Donation
A Walmart Gift Card Donation
Monetary commitment:
*
Total of cash and/or checks.
*Amount needed according to family size: 2/$100, 3/$125, 4/$175, 5/$200, 6/$250, 7/$275
Total Commitment Value:
*
TOTAL combined commitment of cash, checks + Walmart card.
*Please label your donation(s) “Adopt a Family” and turn it into the church office or put it in an offering basket by 12/4/17.
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Email
This field is for validation purposes and should be left unchanged.
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Adopt-a-Family Referral
My Name
*
My Phone Number
*
My Email Address
*
Enter Email
Confirm Email
Family I am Referring
*
Example: John Smith Family
Please List ALL Family Member Names If Possible - Place child ages next to their names
*
Example: John & Susan Smith - John Jr. (18), Billy (8), Suzie (2)
Family Address Information (give us what you know)
Street Address
Address Line 2
City
ZIP Code
Family Contact Phone Number and/or Email Address
*
Date
MM
DD
YYYY
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