Name *

First Name

Last Name

Phone *

(###)

###

####

Text Messaging

Yes

No

Donating as... *

An organization

An individual/family

What age range will you target for toys/gifts?

We are in need of gifts for all ages. Check all that apply

Infant to Toddler

Pre-K to Kindergarten (Ages 4 – 5)

Elementary School (Ages 6 – 10)

Middle School (Ages 11 – 13)

High School (Ages 14 – 18)

Will you take your toys and gifts to the Benton Convention Center on December 15th or an alternate drop location before December 15th?

Will drop off at Benton on December 15th

Will drop off at Alternate Location before December 15th

Will be unable to drop off (we will make arrangements for a team member to pick up your donation)