LATE SIGN UP – Santa's Angels

I am nominating?(Required)

Name of the Parent or Guardian - Who are we visiting?(Required)

Please use the person that we will arrange the visit with.

First Last

Address - Where will we visit?(Required)

Street Address Apartment number City Province Postal Code

Please verify the address is correct

Pick the are that best matches the address(Required)

Charlottetown Map

Will this person be moving before Christmas?(Required)

Yes

Unsure

Their Email(Required)

Their Phone(Required)

Can we leave a detailed voicemail at this phone number?(Required)

Yes

Are their pets afraid of visitors?(Required)

Yes

Unsure

I confirm that this person knows they are being nominated(Required)

Yes

Are there Children in the house under 17?(Required)

Yes

How many Children?(Required)

1. Child's Name(Required)

First

1. Age(Required)

1. Gender(Required)

Male

Female

Prefer not to answer

1. Are they afraid of Santa?(Required)

Yes

Unsure

1. What are their interests? (pick one choice)(Required)

We can't guarantee that we can accommodate all requests. Santa's Angel's doesn't bring electronics or video games for children. Teenagers - over 12 will receive a gift of a backpack with hats, mitts, sock and candy inside.

2. Child's Name(Required)

First

2. Age(Required)

2. Gender(Required)

Male

Female

Prefer not to answer

2. Are they afraid of Santa?(Required)

Yes

Unsure

2. What are their interests? (pick one choice)(Required)

3. Child's Name(Required)

First

3. Age(Required)

3. Gender(Required)

Male

Female

Prefer not to answer

3. Are they afraid of Santa?(Required)

Yes

Unsure

3. What are their interests? (pick one choice)(Required)

4. Child's Name(Required)

First

4. Age(Required)

4. Gender(Required)

Male

Female

Prefer not to answer

4. Are they afraid of Santa?(Required)

Yes

Unsure

4. What are their interests? (pick one choice)(Required)

5. Child's Name(Required)

First

5. Age(Required)

5. Gender(Required)

Male

Female

Prefer not to answer

5. Are they afraid of Santa?(Required)

Yes

Unsure

5. What are their interests? (pick one choice)(Required)

6. Child's Name(Required)

First

6. Age(Required)

6. Gender(Required)

Male

Female

Prefer not to answer

6. Are they afraid of Santa?(Required)

Yes

Unsure

6. What are their interests? (pick one choice)(Required)

7. Child's Name(Required)

First

7. Age(Required)

7. Gender(Required)

Male

Female

Prefer not to answer

7. Are they afraid of Santa?(Required)

Yes

Unsure

7. What are their interests? (pick one choice)(Required)

8. Child's Name(Required)

First

8. Age(Required)

8. Gender(Required)

Male

Female

Prefer not to answer

8. Are they afraid of Santa?(Required)

Yes

Unsure

8. What are their interests? (pick one choice)(Required)

9. Child's Name(Required)

First

9. Age(Required)

9. Gender(Required)

Male

Female

Prefer not to answer

9. Are they afraid of Santa?(Required)

Yes

Unsure

9. What are their interests? (pick one choice)(Required)

Are there adults (18+) who, due to intellectual/ developmental challenges, still believe in Santa?(Required)

Yes

How many people?(Required)

1. Their name

First

1. What are their interests? (pick one choice)

2. Their name

First

2. What are their interests? (pick one choice)

3. Their name

First

3. What are their interests? (pick one choice)

4. Their name

First

4. What are their interests? (pick one choice)

5. Their name

First

5. What are their interests? (pick one choice)

Will we be visiting any people over age 65?(Required)

Yes

How many people over 65?

Their Name(Required)

Does this Family need food?(Required)

Yes

Unsure

Their biggest need?(Required)

Gifts and Food

Joy and Christmas Spirit

Please tell us anything else about the Family that would be helpful.

Now please tell us about you(Required)

First Last

Your Email(Required)

Your Phone Number(Required)

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last minute visit

LAST MINUTE VISIT