2025 Affordable Christmas Shopper Request Form
Spots are limited. Shoppers are selected randomly
.
Shopping details will be sent out via text message on December 3rd. The main event takes place Saturday, December 13th from 8am-noon.
SHOPPER INFORMATION
Legal First Name
Last Name
Preferred First Name (
Fill this out if you go by a name different than your full legal name
)
Birthdate (mm/dd/yyyy)
Email
Address
City:
State
Zip Code
We will be communicating via text.
If your number changes, you must let us know or you will not receive updates! You are agreeing to receive text messages from Mission: St. Louis. You can opt-out at any time, but you will not be invited to attend the event.
Primary Phone Number
Can we text you at your primary number?
Please select...
Yes
No
**If you do not have a phone we can text, you will receive a phone call either way before Tuesday, December 3rd.
Secondary Phone Number
Can we text you at your secondary number?
Please select...
Yes
No
INVOLVEMENT
What brings you to filling out this form for Affordable Christmas?
I am/have been been involved in a program at Mission: St. Louis.
I have
NOT
been involved in a program at Mission: St. Louis.
I was referred to by another organization.
Other
If other, please explain:
If you were referred to Affordable Christmas by another agency who was it?
Which Mission: St. Louis program were you involved in?
Beyond School
Employment/Workforce Development (JLT, Beyond Jobs, Beyond Justice, SkillUP, Tech Training)
Essentials Drives
Home Repair
Senior Services
Show Me Peace
VISTA/AmeriCorps
Other
If other, please explain:
Who did you work with at Mission: St. Louis?
CHILDREN
How many children will you be shopping for?
1
2
3
4
5
6
Child #1 Name
Age
Please select...
Under 1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
Gender
Please select...
Male
Female
Other
Child #2 Name
Age
Please select...
Under 1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
Gender
Please select...
Male
Female
Other
Child #3 Name
Age
Please select...
Under 1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
Gender
Please select...
Male
Female
Other
Child #4 Name
Age
Please select...
Under 1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
Gender
Please select...
Male
Female
Other
Child #5 Name
Age
Please select...
Under 1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
Gender
Please select...
Male
Female
Other
Child #6 Name
Age
Please select...
Under 1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
Gender
Please select...
Male
Female
Other
INTERESTS
My children are interested in (check all that apply):
Action Figures
Arts, Crafts & Science Kits
Baby Items
Toddler Toys
Beauty & Jewelry
Books & Puzzles
Cars, Trains & Remote Control.
Clothing
Dolls
Dress-Up
Legos & Blocks
Sports Equipment
Stuffed Animals
What items are on the top of your child(ren)'s wishlist?
The retail value of toys typically ranges from $5-$100.
Have you participated in Affordable Christmas in years past?
Yes
No
Other than offering gifts, winterwear and breakfast, what would make Affordable Christmas more impactful to you and your family?
How did you hear about Affordable Christmas?
Text
My Coach
I was at Mission: St. Louis
Friend/Family
Social Media
This is a tradition!
Other
Please explain:
Completed Intake Form Name (NEED TO EDITS)
Affordable Christmas Shopper Request Form
If you have any questions please text 314.310.3644 or call our main office at 314.534.1188..