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About Us
Menu Toggle
Our Team
Contact Us
Events
Menu Toggle
Ballroom Blitz
Bamboozle
Community Events
Golf Tournament
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Stars Ball
Programs
Gallery
Menu Toggle
Video Gallery
Photo Gallery
Volunteer
Donate Now
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Url
Company, School or Organization (if applicable)
*
Number of Boxes Requested:
*
First Name
*
Last Name
*
Street Address
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City, State, Zip
*
Email
*
Preferred Phone Number
*
Are you able to pick up boxes from the Little Smiles office in Palm Beach Gardens?
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Yes
No
If your boxes need to be delivered, what is your preferred box drop off date? (Please note this is not a garunteed date, a Little Smiles representative will contact you to schedule your delivery.)
*
Boxes will be scheduled for pickup between 12/11-12/15, what is your preferred box pickup date? (A Little Smiles representative will reach out to you to schedule your pick up. Please note all boxes that a requested to not be picked up during this time will need to be dropped off to the Little Smiles North Pole or Little Smiles Office; otherwise boxes will not be picked up until after the New Year.)
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Can we contact you before the pick up date to do a partial pick up?
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Yes
No
Are you a Marine Industries of Palm Beach County Member?
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Yes
No
This Donation Box Will Be
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Private
Open to the public to drop off at
If open to the public, what days/times can people stop by?
Can your collection site be listed on our website?
*
Yes
No
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