SYMin clients who have custody or play an active role in their children's lives can request a Christmas gift for each of their children through our Strengthening the Family program. The gifts will be new to the client and could include an age-appropriate book, a developmental toy, and other goodies.

Please fill out this form and provide us with each child's name and age for whom you wish to receive a gift. We ask for ages so that we can customize the basket to each child's age.

For this gift, you must be able to pick up your children's Christmas gift in person at our location at 2008 Justin Lane during the Sunshine Store Hours between Monday Dec 16 and Thursday, December 19th, or Friday, December 20th during our Christmas party. Gifts not picked up are forfeit and we cannot ship.

**Note: Priority will be given on a first-come, first-served basis, particularly to clients who are actively engaged with us (attendance in at least three groups in the last 30 days). Requests that do not provide requested information will not be accepted.**

Legal First Name

Legal Last Name

Date of birth

Are you a current client who has participated in at least 3 SYMin groups in the last 30 days? YesNo

Email

Phone

Zip

What is your first child's name?

What is your first child's date of birth?

First Child Relationship Child lives with meI regularly visit childOther

Did you participate in the 2023 Strengthening the Family Christmas program? YesYes but I failed to receive my child's giftNo

Will be able to pick up your child's gift from the SYMin location (2008 Justin Ln) on the dates and times listed at the top of the form? YesNo

I understand there is a limited supply of gift basekts. Filling out this form does not guarantee I will receive a gift for my child(ren). I understand.

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