Impact Form for Beds for Kids - Formstack

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Beds For Kids Fund : Positive Feedback Form

Please complete the attached Form that will provide Beds For Kids with the knowledge of how this Grant has assisted the recipients.

We learn from your feedback of how to make this journey in helping babies and children an even more beneficial experience.

Thank You for your assistance.

Wishing you a Blessed Day,

Danny and Barbara Sergi

Impact

Original Request Date*

Organization Contact Name*

Organization Contact Email*

Date Funds Received*

Amount Granted to Organization*

Delivery Date(s) of Beds and/or Cribs*

Total Number of Cribs Granted*

Total Number of Beds Granted*

File - Copy

No File Chosen

File uploads may not work on some mobile devices.

Total Number of Families Served*

Total Number of Children Served*

Age(s) of Child(ren) Served*

Pictures

No File Chosen

File uploads may not work on some mobile devices.

Please upload pictures of the child(ren) and family(ies) receiving beds.

Pictures - Copy

No File Chosen

File uploads may not work on some mobile devices.

Please upload pictures of the child(ren) and family(ies) receiving beds.

Pictures - Copy

No File Chosen

File uploads may not work on some mobile devices.

Please upload pictures of the child(ren) and family(ies) receiving beds.

Pictures - Copy

No File Chosen

File uploads may not work on some mobile devices.

Please upload pictures of the child(ren) and family(ies) receiving beds.

Story Sharing of Family(ies) After Received Bed(s) Crib(s)Arrival*

Thank you note(s) from family(ies)

Save and Resume Later

Progress

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