2010 ADOPT-A-FAMILY

With the 2010 holiday season rapidly approaching, we are looking forward to a 14th successful season of giving.  Supports to Encourage Low-income Families' (SELF) program differs from other holiday-giving programs in that the recipients of this holiday help are actively working toward self-sufficiency through one of SELF's programs.  Additionally, SELF is a member of the Butler County Holiday Collaborative, which ensures that clients who sign up for holiday programs through this network can only receive holiday assistance from one agency. 

Supports to Encourage Low-income Families (SELF) would like to match willing sponsors with one of our needy families working toward self-sufficiency for the purpose of providing them with gifts & necessities this holiday season. This year we will also like to offer sponsors the option of donating money to provide a holiday meal for the families.

Your agreement to sponsor a family includes:

• Minimum of $50 spent per adult and $75 spent per child (18 years of age and younger).* ----AND/OR----
• Minimum of $25 to provide Kroger food vouchers for one family or single individual.
• All gifts should be wrapped.
• You will contact us no later than December 3, 2010 to make arrangements to deliver the items.
• To respect the privacy of our families, you will deliver the gifts to our location at 1790 S. Erie Hwy, Suite A&B, Hamilton, Ohio.
  
  *Remember, the dollar amount listed per person is a minimum. If you would like to exceed the amount listed, you may do so. If you have a question about spending amounts, please contact Vanessa Jackson at 513-820-5017.

Yes, I accept responsibility for adopting a family for the holiday, according to the agreement above.
How many individuals would you like to sponsor? Please Select 1 2 3 4 5 6 7 Or More
Would you be willing to sponsor a single adult or an adult couple, working toward self-sufficiency? Yes No
Name:	Mr. Ms. Mrs. First Name: Last Name:
Business or Group Name:
Address Line 1:
Address Line 2:
City:	State: Zip:
Phone:
Alternate Phone:
Fax:
E-mail:
Preferred Method of Contact:	Email Phone Fax
Questions or Comments:
Your submission of this form indicates your willingness to release your contact information to SELF staff only for purposes of coordinating the Adopt-a-Family program. SELF respects your privacy and will not share your contact information outside of the agency.

Enter the text above:

Important Dates to Remember
October 29, 2010	Last opportunity to sign up to sponsor a family.
November 17, 2010	Adopted Family/Sponsor matches completed
November 29, 2010	Contact Vanessa to make arrange delivery to SELF at (513) 820-5017.
December 3, 2010	Last day to deliver gifts.

Monetary Donations

If you prefer to donate money for this program, please make your check or money order to “SELF” and indicate in the memo line that your donation is to be designated to the “Adopt-a-Family” program.

Mail your donation to:

SELF
Adopt-a-Family Program
P.O. Box 1322
Hamilton, OH 45011