Register an Angel

Apply for Senior Christmas

Nothing embodies the spirit of giving around the holidays more than FreeHelpCK’s Adopt a Senior program. For the 7th consecutive year, our organization will focus on this upcoming holiday season by accompanying and delivering a festive holiday dinner and gifts to seniors who are alone on Christmas Eve. 

Please complete all the information in the following form to nominate a senior or apply for yourself for our 2025 Adopt a Senior program.

BEFORE COMPLETING THE FORM BELOW, PLEASE MAKE SURE YOU MEET THE ELIGIBILITY CRITERIA FOR THIS PROGRAM.

  • You are over the age of 65
  • You live alone and have no family
  • You have limited mobility and are unable to get out

Refer A Senior

Please review the program criteria below to determine whether the senior you would like to refer meets the eligibility requirements.

  • Senior is over the age of 65
  • Senior lives alone and is receiving no family support / in-home care
  • Senior has the means to leave their home
  • Senior is unable to prepare their own meals due to health issues
  • Senior cannot afford to purchase meals

If the senior meets the eligibility requirements listed above, please complete the referral form below. A FreeHelpCK representative will contact you within 48 hours to review the referral. Our team will review your referral with care and help ensure this senior receives the support they need.

Refer A Senior

Senior's Name(Required)
Senior's Address(Required)
Help Us Get To Know This Senior's Situation(Required)
Please check all that apply
Allergies / Dietary Restrictions(Required)
Your Name(Required)
Please let us know why you believe this senior requires this service.
Privacy Statement(Required)