Office Use Only… ____Adopt-A-Family
_____ Giving Tree
Date Received: _______________ _____ Adopt-A-Senior
The Salvation Army Harrisburg Capital City Region Sponsor Registration Form 2016
Company/Family Name: Contact Person: Street Address: City/State/Zip: Phone: Fax: Email: Able to help non-English speakers? YES? NO? Please specify language!
Program Information & Requirements: Please use the information below to make a decision on participation. Additional program specifics will be sent after registration form is received. √ Program Requirements Family Size/Tag Qty Provide gift card to grocery store or # of families you ingredients for holiday dinner which would like to adopt includes: turkey or ham, potatoes, # of children in family noodles, vegetables, gravy, pie filling, pie 1-2 crust, bread, stuffing mix, cranberry sauce Adopt-A-Family At least 1 gift per child as well as an outfit, 3-4 hat and gloves.
Optional: gift for adults
Provide gift card to grocery store (please ask the senior if they are able to get to the store) or ingredients for holiday dinner which includes: turkey or ham, potatoes, noodles, vegetables, gravy, pie filling, pie crust, bread, stuffing mix, cranberry sauce Optional: gift for the senior
Adopt-A-Senior Giving Tree
Receive Giving Tree tags and make available to others by distribution or hanging them in a visible area. Please provide a clothing item and a toy/gift for each tag. Sizes and gift ideas are located on each tag. Please do not wrap the gifts. Gifts must be well marked with the corresponding tag number. You may keep the top of the tag as a reminder of the child you helped.
Delivery Deliver to the family at their home by December 11, 2016 OR Deliver to The Salvation Army by December 14, 2016.
5+ # of senior households you would like to adopt Single(s) Couple(s) No preference Quantity of tags requested:
#
Deliver to the senior at their home by December 11, 2016 OR Deliver to The Salvation Army by December 14, 2016. Deliver the gifts to The Salvation Army distribution site: Harrisburg Military Post Armory, 1400 Calder Street, Harrisburg PA 17103 December 7th-9th.
Return form to: The Salvation Army via mail, fax, or email. P.O. Box 61798, Harrisburg, PA 17106 Fax: 717-231-3650 Scan & email to:
[email protected] For additional information, contact Melissa Snyder, Family Services Administrator at 717-233-6755 ext. 111 or by email at
[email protected]. **Thank you for helping this Christmas season!**