Adopt a family application by lanyuehua


									                                    The Lord’s Pantry at Anna’s House
                                           303 N. Elder Ave.
                                         Indianapolis, IN 46222
                             Christmas Adopt-A Family Application
Date: __________________       Have you adopted a family with us in the past? Yes No

Name of Sponsor (Family) Group or Organization: ______________________________________________________

Name of Contact Person: _________________________________________________________________________________

Address: __________________________________________________________________________________________________
               Street                                  City                    State          Zip

Phone Number: _________________________________________        Work Home Cell Pager Other (circle one)

Alternate Phone: ________________________________________      Work Home Cell Pager Other (circle one)

Email address: ___________________________________________________________________________________________

Family Request (our families range in size from 4 to 10 people)

Number of families: ____________        Size of family: ________________

Children ages 14-18 okay? ______________________

Other family characteristics desired: ___________________________________________________________________

If possible, would you like to adopt the same family you had last year? Yes No

Program deadline: All gifts must be delivered directly to the family by Saturday, Dec 17th.
Recommendations for adopting a family:
  1. Food: Please provide a gift card to a local grocery store for the family to purchase items for
     a Christmas dinner. Gift cards are recommended so that families may pick items that fit
     their traditions and taste. We recommend a minimum of a $50 gift card for a family of four.
  2. Adult Gifts: Please provide at least one new gift for each adult in the household.
  3. Children: Please provide at least one new toy or game for each child 18 years and younger.
  4. Clothing: Please provide an outfit of clothing and shoes for each child in the sizes provided
     (if requested by the family).
You’re welcome to provide any additional items for the family such as household cleaning items or
toiletries. All the gifts should be wrapped and tagged with the recipient’s name (except for food,
cleaning supplies or toiletries).
This form can be emailed to or mailed to The Lord’s Pantry,
P.O. Box 17104, Indianapolis, IN 46217 no later than December 7th. You or your organization
will be matched with a family within a week of receiving your application. The information on
your adopted family will be emailed to you.

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