Christmas Wallet Register

Foster Adventure is now accepting applications for our Christmas Wallet Program.

If you have a teen in West Virginia Foster Care (or know of one) please use the form below to submit their information.

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Our goal is to provide teens with a wallet filled with gift cards to some of their favorite stores.

If we are able to serve your youth, you will receive a letter and a pick up card with your child’s name and reference number with the dates and times of distribution.

PLEASE BE SURE TO INCLUDE PROPER MAILING AND EMAIL ADDRESSES SO THIS INFORMATION WILL GET BACK TO YOU.

DISCLAIMER: Registration with Foster Adventure does not guarantee that you will receive a gift or gifts. Confidentiality is maintained: Only first name and code number are issued. I certify that I have NOT applied to any other organization for assistance. I certify that all information is correct to my knowledge. I authorize Foster Adventure to share basic, identifying and non-confidential information/service transactions with other participating agencies. I authorize the use of a copy of this original to serve as an original for the purposes stated above. I further authorize Foster Adventure to share my dependent’s basic, identifying and non-confidential service transactions/information with other participating agencies.

Your Name/Agency (required)

Address Address

Phone

Your Email (required)

Teen's FULL Name (required)

Teen's Age(required)

Teen's Gender(required)

Teen's County

How long has the Teen been in care

Placement type

Teen's Favorite Stores

Any other information you would like to share with us?

Delivery details or where to send gift(s)

Your Digital Signature (required)