Adopt a Family Program - Detroit Rescue Mission Ministries

-PLEASE READ AND COMPLETE ENTIRE FORM
-COMPLETE EACH REQUIRED AREA FOR EACH CHILD IN YOUR FAMILY

AFTER reading the information below and completing the form, please type your name at the bottom to be considered for Christmas help.

*I agree to all terms of this program.

*I have completed the application in full and supplied all paperwork. If any documents are missing, application will not be considered.

*I have the appropriate proof identifying that my children live at home with me at my address.

*I understand that by filling out this application and submitting to DRMM that I am not guaranteed adoption, and that I am not promised, entitled, or guaranteed to any certain amount of gifts. If my family is adopted, it is a blessing and that I will graciously appreciate whatever the sponsor has purchased for my family. DRMM does not open gifts provided to clients by sponsors of this program and is NOT responsible for gifts that are not returned by sponsors, gifts that are not the right size, or gifts that are lost or stolen if not picked up on the designated date and time on the approval letter. If the gifts are not picked up at this time, they will be forfeited to DRMM.

*This program is based on need. Sponsors won't be purchasing any electronic devices, phones, computers, game systems, or other items too large to fit inside a bag. We will not call or deliver gifts at any other time.

*I understand that I am only allowed to sign up with ONE agency for help at the Christmas holiday and that DRMM will not approve applicants that have already signed up for help with another organization, including Goodfellows, Salvation Army, Church Giving Trees, Volunteers of America, Toys for Tots, or any other non-profit Christmas program.

*I agree to allow pictures of me and/or my family to be taken and used as DRMM sees fit, including use for publicly, internally, and/or online website use.

*If you are sponsored, you will be called to pick up your claim ticket. You must come pick it up and if it is lost, you will not be issued another. Be sure to take a picture of it or keep it safe.

Your Email *

Mother's Name *

Father's Name

Number of Eligible Children for Application:

age newborn to 16 years

Church Name

Phone Number *

Second Phone Number

Brief overview of this client's testimony

Permanent Home Address

City

State

Zip Code

Parent or Guardian's Last Name

Family's last name and family number must be put on all bags, boxes, and packages

Please fill out the info below for each child in your custody, living with you.

CHILD 1:

Child 1: Name, Age, Height, Weight, and Gender

Children age 0-16 in your custody, living with you

Child 1: Clothing Category

(for 1st child listed)

Child 1: Shirt Size

Child 1: Pant Size

Child 1: Shoe Size

Child 1: Choose six (6) items from the list

(for 1st child listed)

Child 1: Favorite item or toy (DO NOT INCLUDE ANY ELECTRONICS, GAME SYSTEMS, PHONES, IPADS, OR LARGE ITEMS):

(for 1st child listed)

CHILD 2:

Child 2: Name, Age, Height, Weight, and Gender

Children age 0-16 in your custody, living with you

Child 2: Clothing Category

(for 1st child listed)

Child 2: Shirt Size

Child 2: Pant Size

Child 2: Shoe Size

Child 2: Choose six (6) items from the list

(for 1st child listed)

Child 2: Favorite item or toy (DO NOT INCLUDE ANY ELECTRONICS, GAME SYSTEMS, PHONES, IPADS, OR LARGE ITEMS):

(for 1st child listed)

CHILD 3:

Child 3: Name, Age, Height, Weight, and Gender

Children age 0-16 in your custody, living with you

Child 3: Clothing Category

(for 1st child listed)

Child 3: Shirt Size

Child 3: Pant Size

Child 3: Shoe Size

Child 3: Choose six (6) items from the list

(for 1st child listed)

Child 3: Favorite item or toy (DO NOT INCLUDE ANY ELECTRONICS, GAME SYSTEMS, PHONES, IPADS, OR LARGE ITEMS):

(for 1st child listed)

CHILD 4:

Child 4: Name, Age, Height, Weight, and Gender

Children age 0-16 in your custody, living with you

Child 4: Clothing Category

(for 1st child listed)

Child 4: Shirt Size

Child 4: Pant Size

Child 4: Shoe Size

Child 4: Choose six (6) items from the list

(for 1st child listed)

Child 4: Favorite item or toy (DO NOT INCLUDE ANY ELECTRONICS, GAME SYSTEMS, PHONES, IPADS, OR LARGE ITEMS):

(for 1st child listed)

CHILD 5:

Child 5: Name, Age, Height, Weight, and Gender

Children age 0-16 in your custody, living with you

Child 5: Clothing Category

(for 1st child listed)

Child 5: Shirt Size

Child 5: Pant Size

Child 5: Shoe Size

Child 5: Choose six (6) items from the list

(for 1st child listed)

Child 5: Favorite item or toy (DO NOT INCLUDE ANY ELECTRONICS, GAME SYSTEMS, PHONES, IPADS, OR LARGE ITEMS):

(for 1st child listed)

CHILD 6:

Child 6: Name, Age, Height, Weight, and Gender

Children age 0-16 in your custody, living with you

Child 6: Clothing Category

(for 1st child listed)

Child 6: Shirt Size

Child 6: Pant Size

Child 6: Shoe Size

Child 6: Choose six (6) items from the list

(for 1st child listed)

Child 6: Favorite item or toy (DO NOT INCLUDE ANY ELECTRONICS, GAME SYSTEMS, PHONES, IPADS, OR LARGE ITEMS):

(for 1st child listed)

I have read the requirements at the top of this form and completed all required areas to be considered for Christmas help.

(Type name above)

A copy of your responses will be emailed to the address you provided.

Services

Annual Adopt a Family Program