Community Card Program

Recipient Name for the Envelope *

What name should be printed on the envelope to avoid any possible safety issues, or outing the recipient.

Recipient Name for the Card

What name would you like used on the card, if different from the envelope?

Recipient Address *

Recipient Birthdate *

Recipient Pronouns *

Message *

Would you like to include a specific message? Tell us about the recipient so we can customize the message. Are they part of the LGBTQIA+ community, and is it safe to mention that in the message?

The return address will list Muncie OUTreach, would you like this left off? *

Yes
No