Single Parent - Holiday Blessing

If you are a single parent, we would like to bless you and your children (ages 0-18) this holiday season. Please complete the information form by the November 30, 2024 deadline.

Please note you must be a member of New Hope to participate.

Parent Information

Parent First Name *

Parent Last Name *

What is your phone number? *

What is your email address? *

Street Address *

Apt/Unit

City *

State *

Zip Code *

Please tell us three things you enjoy (e.g candles, movies, coffee, dining out) *

Can you be in attendance at church on December 15, 2024? *

Yes

Maybe

Child(ren) Information

How many children do you have? *

Child #1 Name *

Child #1 Age *

Child #1 Date of Birth * +

Child #2 Name *

Child #2 Age *

Child #2 Date of Birth * +

Child #3 Name *

Child #3 Age *

Child #3 Date of Birth * +

Child #4 Name *

Child #4 Age *

Child #4 Date of Birth * +

Child #5 Name *

Child #5 Age *

Child #5 Date of Birth * +

Child #6 Name *

Child #6 Age *

Child #6 Date of Birth * +