Heartland for Children

Rudolph Round-Up Commitment Form

Become a Rudolph Champions in 2020!

Pledge your commitment today by filling out the information at the bottom of this form.

Your Rudolph Round-Up contact is
Vereuch Simmons, Prevention Specialist.
Phone: 863-519-8900 x 214
Fax: 863-519-8912
Address: 1239 E Main St. Bartow, FL 33830
Email: Rudolph@heartlandforchildren.org

* indicates required

Contact Name

Organization (if applicable) *

Address

City

State

Zip

Phone

Please send me wishlists for ___ # of children.

Last Name

How do you want to get involved?

Sponsor a child or children.
Sponsor a toy drive for infants.
Sponsor a toy drive for teenage boys and/or girls ages 13 to 17 years old.
Sponsor a toy drive for children of all ages.
Make a monetary donation which will be used to purchase gifts.

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