Love, Joy, Peace...

For families residing in the 43211 zip code, Fresh Start will be blessing the first 20 families who register, with a holiday food box and toys for children ages 0-12.  Please complete the form below and a representative will contact you. Thank you!

First & Last Name of adults in the home (Required)
Address (Required)
Please provide your full address with the City, State and Zip code
Phone (Required)
E-mail Address
Name, Gender and date of Birth of each Child (Required)
Please list the name, date of birth and gender of each child in the home.
Comments
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