This is only a preview. No submissions will be saved, nor will emails be sent.
Name
*
$
First Name
Last Name
$
One Time
Recurring
Organization
*
$
$
One Time
Recurring
Email
*
$
$
One Time
Recurring
Address
*
$
Address Line 1
Address Line 2
City
State
Zip
$
One Time
Recurring
Phone
*
$
$
One Time
Recurring
How many families would you like to adopt?
*
1
2
3
4
5
$
$
One Time
Recurring
Type of Family to Adopt
*
$
Oxnard PAL - teen siblings & parents of children receiving gifts from Oxnard PAL (one gift each person, $25-40 each)
Full family - I will adopt all members of a family sized 2-5 ($50 per person)
Full family - I will adopt all members of a family sized 6-10 ($50 per person)
$
One Time
Recurring
Note
*
$
$
One Time
Recurring
I agree to:
*
$
Complete purchases for all families I adopt, Wrap and label each gift, Deliver gifts in Oxnard on the specified date (ranging from 12/07 - 12/15)
$
One Time
Recurring
I confirm:
*
$
I will not share personal information of any families in the program, attempt to contact any families, or attempt to introduce myself as the sponsor to any families receiving gifts.
$
One Time
Recurring
I confirm:
*
$
All gifts provided will be purchased new. I will not gift any used items. All items will be in their original packaging.
$
One Time
Recurring