Jingle Bells Foundation
PO Box 635
Alexandria, MN 56308

Basket Request

 

Basket Requests

Basket Requests will be accepted through December 4th, 2017.

Baskets are limited – PLEASE request early!

Delivery of baskets is scheduled for December 10th, 2017.

All basket requests must be submitted on this page of this website

Please enter your physical address only.
Addresses will be verified and deliveries will only be made to individuals residing at the listed address.
Household size is inclusive of individuals living in the home on a full time basis.

Recipient First Name (required)
Recipient Last Name (required)
Requester's Email (required) if no email, please enter jinglebellsbaskets@gmail.com


Address (No PO Boxes)
Recipient House Number or Building Number (required)
Recipient Street Name (required)
Recipient Apartment Number

Recipient City, Zipcode (required)

 

Recipient's Phone (required)

Requester's Phone (required)

Directions to Recipient's Home (required)

Adults in Recipient Household (Full Time) (required)

Children in Recipient Household (Full Time) (required)


Child 1
First Name
Last Name
Date of Birth (mm/dd/yyyy)
Gender
Child's Interests. Examples: barbie, books, trucks, etc... 10 words maximum.

No Gift Wanted

If requesting a bike for your wish list - specify the size needed. Click for Sizing Chart
No Bike Requested12"14"16"18"20"24"26"


Child 2
First Name
Last Name
Date of Birth (mm/dd/yyyy)
Gender
Child's Interests. Examples: barbie, books, trucks, etc... 10 words maximum.

No Gift Wanted

If requesting a bike for your wish list - specify the size needed. Click for Sizing Chart
No Bike Requested12"14"16"18"20"24"26"


Child 3
First Name
Last Name
Date of Birth (mm/dd/yyyy)
Gender
Child's Interests. Examples: barbie, books, trucks, etc... 10 words maximum.

No Gift Wanted

If requesting a bike for your wish list - specify the size needed. Click for Sizing Chart
No Bike Requested12"14"16"18"20"24"26"


Child 4
First Name
Last Name
Date of Birth (mm/dd/yyyy)
Gender
Child's Interests. Examples: barbie, books, trucks, etc... 10 words maximum.

No Gift Wanted

If requesting a bike for your wish list - specify the size needed. Click for Sizing Chart
No Bike Requested12"14"16"18"20"24"26"


Child 5
First Name
Last Name
Date of Birth (mm/dd/yyyy)
Gender
Child's Interests. Examples: barbie, books, trucks, etc... 10 words maximum.

No Gift Wanted

If requesting a bike for your wish list - specify the size needed. Click for Sizing Chart
No Bike Requested12"14"16"18"20"24"26"


Child 6
First Name
Last Name
Date of Birth (mm/dd/yyyy)
Gender
Child's Interests. Examples: barbie, books, trucks, etc... 10 words maximum.

No Gift Wanted

If requesting a bike for your wish list - specify the size needed. Click for Sizing Chart
No Bike Requested12"14"16"18"20"24"26"


Child 7
First Name
Last Name
Date of Birth (mm/dd/yyyy)
Gender
Child's Interests. Examples: barbie, books, trucks, etc... 10 words maximum.

No Gift Wanted

If requesting a bike for your wish list - specify the size needed. Click for Sizing Chart
No Bike Requested12"14"16"18"20"24"26"


Child 8
First Name
Last Name
Date of Birth (mm/dd/yyyy)
Gender
Child's Interests. Examples: barbie, books, trucks, etc... 10 words maximum.

No Gift Wanted

If requesting a bike for your wish list - specify the size needed. Click for Sizing Chart
No Bike Requested12"14"16"18"20"24"26"


Child 9
First Name
Last Name
Date of Birth (mm/dd/yyyy)
Gender
Child's Interests. Examples: barbie, books, trucks, etc... 10 words maximum.

No Gift Wanted

If requesting a bike for your wish list - specify the size needed. Click for Sizing Chart
No Bike Requested12"14"16"18"20"24"26"


Child 10
First Name
Last Name
Date of Birth (mm/dd/yyyy)
Gender
Child's Interests. Examples: barbie, books, trucks, etc... 10 words maximum.

No Gift Wanted

If requesting a bike for your wish list - specify the size needed. Click for Sizing Chart
No Bike Requested12"14"16"18"20"24"26"


I acknowledge that all individuals listed on this form reside in the home full time and that I am not ordering food or toys for others outside of the home of the recipient

The Alexandria Jaycees (and The Jingle Bells Foundation) appreciate all of the efforts made in our community to ensure the success of Jingle Bells!