Please tell us about your Sponsored Child

Child's Gender:
Select a Gender Male Female

Child's Birthday:
Month Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Day 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

Which age range do you desire for this child?
Select a Gender 2-4 5-7 8-12 Teen College

Which JoyPak! version are you requesting for this child?
Standard Deluxe

City:

State:
Select a State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska New Hampshire Nevada New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip:

Child's Ethnicity (optional; used to match certain gift items that reflect an ethnicity): Select... African American Asian Caucasian Hispanic Other

My sponsored child likes the following color(s) (optional):

Green Blue Pink Purple YellowOrange
Other color (please specify):

What is your relationship to the sponsored child?
Select... Mother Father Grandmother Grandfather Aunt Uncle Foster Parent Other

What does the sponsored child call you (e.g., Nana, Uncle Jim)?

What do you call the sponsored child?

First Parent/Guardian at child's address

First Name:

Last Name:

Relationship: Select... Mother Father Grandmother Grandfather Aunt Uncle Foster Parent Other

Email Address:

Second Parent/Guardian at child's address

First Name:

Last Name:

Relationship: Select... Mother Father Grandmother Grandfather Aunt Uncle Foster Parent Other

Email Address:

Please tell us about Yourself

Name:

Email:

Phone:

Address:

City:

State:
Select a State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska New Hampshire Nevada New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip: