Baltimore County Department of Social Services
Drumcastle Government Center
6401 York Road, Baltimore, Maryland 21212
410-853-3024, 410-853-3023
FAX 410-853-3025
MS 1102S
Print out application, then fill out and mail to above address.
Name of Organization/Donor_________________________________
Contact Person___________________________________________
Division/Unit______________________________________________
Mailing Address___________________________________________
Zip Code________________________________________________
Phone: Day_____________________ Evening___________________
Fax___________________
MS#__________________________ (for County Agencies Only)
I/We would like to help in the following way(s):
1.____ Adopt-A-Family by providing food, toys/gifts, and possibly clothing.
Number of families_____
Size of family: Small (1-3 people)_____
Medium (4-5 people)_____
Large (6 or more people)_____
2.____ Provide only food to families by giving:
Food Baskets
or
Food Certificates from grocery store | Number_____ Amount $_____ |
3.____ Make a monetary donation for food and toys, payable to:
The Fund for Social Welfare/Holiday Project and send to the above address.
Amount $_____
4.____Donate food gift certificates in denominations of $5 and $10 for older adults.
Amount $_____
5.____Sponsor a party to distribute toys for children.
6.____Set up a gift tree with children's toy wishes.
7.____Help in other ways such as transporting toys, volunteering in our office, etc.
8.____I would like to help at Easter. Please send me information.
Revised August 23, 2004
Courthouse 