Nominate a Child for Bedford County Shop With A Cop

Do You Know An Eligible Child?

Bedford County Shop With A Cop is a memorable relationship building experience between local law enforcement and the children of Bedford County. This event is a once in a lifetime opportunity for both the child and the police officer. Nominating a local child is the first step in helping impact their lives. If you know a child or children who can really use a special holiday season this year, please don’t hesitate to fill out our Nominate A Child form. We would love to be able to take every child nominated holiday shopping, but we receive many applications for this program throughout the year. We cannot guarantee acceptance into this program.

Who is Eligible?

For a child in to be eligible they must reside in Bedford County, PA, school aged, and meet one of the following criteria:

A victim of crime
Financial hardship
Extenuating circumstance outside of their control (loss of a loved one, house fire, etc.)

Who Can Nominate A Child?

Any human service/social service organization, church or school can nominate a child.

Bedford County Shop With A Cop Nomination Form:

"*" indicates required fields

Child’s Information

Name*

First Middle Last

Age

Home Address*

Street Address City State / Province / Region ZIP / Postal Code

Phone Number*

School Name

Grade Level

Parent/Guardian Name*

First Last

Parent/Guardian Phone Number*

Parent/Guardian Email*

Family Size

Nominator’s Information

Name*

First Middle Last

Home Address*

Street Address City State / Province / Region ZIP / Postal Code

Phone Number*

Email*

What agency do you represent?*

Relationship to proposed recipient

Teacher

Principal

Neighbor

Other

If other, please specify

Ideas or suggestions for the proposed recipient’s likes and dislikes

Please describe how the child you are nominating fits our criteria

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Phone

This field is for validation purposes and should be left unchanged.

Nominate a Child for Bedford County Shop With A Cop

Do You Know An Eligible Child?

Who is Eligible?

Who Can Nominate A Child?

Bedford County Shop With A Cop Nomination Form:

Links

Contact

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