OHHF Holiday Drive Donor Interest
Name & Contact Information
Thank you for supporting Ollie Hinkle Heart Foundation’s Holiday Giving Adopt-A-Family Drive. Please complete this form to share your interest in participating in this year’s event.
First Name
Last Name
Please select your current age group:
Young Adult (18-39)
Adult (40+)
Gender
Please select...
Female
Male
Transfeminine
Transmasculine
Non-binary
Gender-nonconforming
Prefer not to answer
Other
If other, please specify.
Pronouns
she/her
he/him
they/them
prefer not to say
other
If other, please specify.
Race/Ethnicity
Select all that apply:
American Indian or Alaskan Native
Asian or Asian American
Black or African American
Hispanic or Latino/a/x
Native Hawaiian or Other Pacific Islander
White or Caucasian
Prefer not to answer
Other
If other, please specify.
Email
Phone Number
Phone type:
Please select...
Mobile
Home
Work
Other
If other, please specify.
Donation Information
Which market are you interested in supporting?
St. Louis
Chicago
Bay Area
No preference
How many people are you interested in supporting during the OHHF Holiday Adopt-a-Family drive?
Please select...
One individual
2-3 individuals
A small family (2-4 people in the same household)
A larger family (5-7 people in the same household)
Other
If other, please specify.
Are you representing a company/business that will be participating in this year's holiday drive?
Yes
No
Business Contacts
Please list your company/business name:
Do you have any additional business contacts who may be interested in supporting this request?
Yes
No
First & Last Name:
Email Address:
Phone Number:
Contact Information