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.

Your Name(Required)

Your Phone

Your Email(Required)

Relationship to Senior(Required)

Senior's Name(Required)

Senior's Age(Required)

Senior's Date of Birth

Senior's Phone(Required)

Senior's Email

Senior's Address(Required)

Street Address City State / Province / Region ZIP / Postal Code Country

Please Pick 3 Gifts You Would Like to Receive(Required)

Christmas Candys / Cookies

Lap Blanket

Personalized Tea Towel

Mug Set

Puzzle Books

What Is Something You Need That Is Not On The List?(Required)

**PLEASE PUT A SIZE IF IT'S AN ITEM OF CLOTHING OR FOOTWEAR**

Sign Up to Volunteer!

Please complete the application below.

Join Our Team!

Step 1 of 3

Contact Information

Your Name(Required)

First Last

Your Phone(Required)

Your Email Address(Required)

Address(Required)

Street Address Address Line 2 City Province Postal Code

Sign Up to Volunteer!

Join Our Team!

Contact Information

Which Program Would You Like To Volunteer For?

Tell Us About Yourself

Register an Angel

Apply for Senior Christmas

Sign Up to Volunteer!

Join Our Team!

Contact Information

Which Program Would You Like To Volunteer For?

Tell Us About Yourself