Holiday Help Project - NHS

Please fill out this survey for each family we'd like help.
Name: 


  1. Please enter the family number.
    1
    2
    3
    4
    5
    6
    7
    8
    9
    10
    11
    12
    13
    14
    15


  1. Family member #1 - Head of Household

    Gender
    Male
    Female


  1. Family member #1 - Head of Household

    Age
    14-18
    19-23
    24-30
    31-40
    41-50
    51-60
    61+


  1. Family member #1 - Head of Household

    Pants/jeans size and brand:


  1. Family member #1 - Head of Household

    Shoe size


  1. Family member #1 - Head of Household

    Hobbies


  1. Family member #1 - Head of Household

    Give us gift ideas for things you *need*:


  1. Family member #1 - Head of Household

    Give us gift ideas for things you *want*:


  1. Family member #1 - Head of Household

    Favorite color:


  1. Family member #1 - Head of Household

    Do you have a working stove and oven?
    Yes
    No


  1. Family member #1 - Head of Household

    Do you have a working microwave?
    Yes
    No


  1. Family member #1 - Head of Household

    Do you have a working crockpot?
    Yes
    No


  1. Family member #1 - Head of Household

    Snacks your family enjoys:


  1. Family member #1 - Head of Household

    What favorite meals does your family enjoy?


  1. Family member #1 - Head of Household

    Are there any foods your family will NOT eat?


  1. Family member #1 - Head of Household

    Do you have a Christmas tree?
    Yes
    No


  1. Family member #1 - Head of Household

    Do you have decorations for your Christmas tree?
    Yes
    No


  1. Family member #1 - Head of Household

    What special needs does your family have?


  1. Family member #2

    Gender
    Male
    Female


  1. Family member #2

    Age:
    13
    14
    15
    16
    17
    18
    19-23
    24-30
    31-40
    41-50
    51-60
    61+


  1. Family member #3

    Age:
    13
    14
    15
    16
    17
    18
    19-23
    24-30
    31-40
    41-50
    51-60
    61+


  1. Family member #4

    Age:
    13
    14
    15
    16
    17
    18
    19-23
    24-30
    31-40
    41-50
    51-60
    61+


  1. Family member #5

    Age:
    13
    14
    15
    16
    17
    18
    19-23
    24-30
    31-40
    41-50
    51-60
    61+


  1. Family member #6

    Age:
    13
    14
    15
    16
    17
    18
    19-23
    24-30
    31-40
    41-50
    51-60
    61+


  1. Family member #7

    Age:
    13
    14
    15
    16
    17
    18
    19-23
    24-30
    31-40
    41-50
    51-60
    61+


  1. Family member #8

    Age:
    13
    14
    15
    16
    17
    18
    19-23
    24-30
    31-40
    41-50
    51-60
    61+


  1. Family member #9

    Age:
    13
    14
    15
    16
    17
    18
    19-23
    24-30
    31-40
    41-50
    51-60
    61+


  1. Family member #3

    Gender:
    Male
    Female


  1. Family member #4

    Gender:
    Male
    Female


  1. Family member #5

    Gender:
    Male
    Female


  1. Family member #6

    Gender:
    Male
    Female


  1. Family member #7

    Gender:
    Male
    Female


  1. Family member #8

    Gender:
    Male
    Female


  1. Family member #9

    Gender:
    Male
    Female





Cheryl Shepherd-Adams