2020 Gift Card Request

    Signing up does not guarantee a gift card. The Jingle Bells Foundation will do our best to honor all requests.

    Please enter your mailing address.
    Addresses will be verified and gift cards 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
    Recipient House Number or Building Number (required)
    Recipient Street Name (required)
    Recipient Apartment Number

    Recipient City, Zipcode (required)

     

    Requester's Phone (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 2
    First Name
    Last Name
    Date of Birth (mm/dd/yyyy)
    Gender

    Child 3
    First Name
    Last Name
    Date of Birth (mm/dd/yyyy)
    Gender

    Child 4
    First Name
    Last Name
    Date of Birth (mm/dd/yyyy)
    Gender

    Child 5
    First Name
    Last Name
    Date of Birth (mm/dd/yyyy)
    Gender

    Child 6
    First Name
    Last Name
    Date of Birth (mm/dd/yyyy)
    Gender

    Child 7
    First Name
    Last Name
    Date of Birth (mm/dd/yyyy)
    Gender

    Child 8
    First Name
    Last Name
    Date of Birth (mm/dd/yyyy)
    Gender

    Child 9
    First Name
    Last Name
    Date of Birth (mm/dd/yyyy)
    Gender

    Child 10
    First Name
    Last Name
    Date of Birth (mm/dd/yyyy)
    Gender

    How did you hear about the Jingle Bells Telethon?
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    I acknowledge that all individuals listed on this form reside in the home full time and that I am not submitting information for others outside of the home of the recipient