Santa'S Questionnaire Template

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Santa’s Questionnaire Form
If you would like your child to receive a letter from Santa, complete the following
questionnaire and return it to Darien Park District Community Center,
7301 Fairview Ave. no later than Monday, November 28.
Please feel free to duplicate the form if you have more than one child.
Please fill out the form completely.
Santa’s
Questionnaire
Child’s Name ___________________________________________________
Boy/Girl (Circle one)
Age _______________
First
Last
Address _______________________________________________________
City _______________________
Zip __________
Home Phone # __________________________________________________
Mom - Dad’s Cell # ___________________________
(Circle one)
Brother’s Names
Age
Sister’s Names
Age
_______________________________________________________
_________________________________________________
_______________________________________________________
_________________________________________________
_______________________________________________________
_________________________________________________
Child’s Wish List
_____________________________________________________________________________________________________________
_____________________________________________________________________________________________________________
_____________________________________________________________________________________________________________
_____________________________________________________________________________________________________________
_____________________________________________________________________________________________________________
_____________________________________________________________________________________________________________
Special Messages _______________________________________________________________________________________________
_____________________________________________________________________________________________________________
Residents - $2 per letter
Non-Residents - $4 per letter
Code# 230005-A
On-line Registration at

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