AngelClaus

AngelClaus is one of our most prized efforts. Through the AngelClaus referral program, AngelWorks is able to provide Christmas gifts to families throughout Ohio with a child battling cancer. Families are nominated by hospital staff, social workers, other cancer families, or teachers. The child’s diagnosis must be confirmed by the treating hospital.

Nominated Child's Name *

First

Last

Parent Name *

First

Last

Parent Name

First

Last

Family Story *

Nominated Child

Nominated Child's Age (Years) *

Nominated Child's Clothing & Shoe Size *

Nominated Child's Wish List *

Family Members

Member 1

Family Member 1 Name

Family Member 1 Age (Years)

Family Member 1 Clothing & Shoe Size

Family Member 1 Wish List

Member 2

Family Member 2 Name

Family Member 2 Age (Years)

Family Member 2 Clothing & Shoe Size

Family Member 2 Wish List

Member 3

Family Member 3 Name

Family Member 3 Age (Years)

Family Member 3 Clothing & Shoe Size

Family Member 3 Wish List

Member 4

Family Member 4 Name

Family Member 4 Age (Years)

Family Member 4 Clothing & Shoe Size

Family Member 4 Wish List

Member 5

Family Member 5 Name

Family Member 5 Age (Years)

Family Member 5 Clothing & Shoe Size

Family Member 5 Wish List

Member 6

Family Member 6 Name

Family Member 6 Age (Years)

Family Member 6 Clothing & Shoe Size

Family Member 6 Wish List

Layout

Delivery Address *

State *

Zip *

Referrer Name *

First

Last

Layout

Referrer Phone *

Can we text you? *

Referrer Email *

Child's Diagnosis *

Case / Social Worker Name *

First

Last

Child's Physician *

First

Last

39929

AngelClaus

Family Members

Every Donation Helps

Join Our Email List

Success!