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It has been a pleasure to serve you once again this year.

Realizing how important it is for us to continue giving back to the community, Miskelly’s would like to donate furniture to families in need. If you would like to nominate a family, please complete the form below and tell us their story.

For a printable version of this form, Click Here

  • Nominee:
  • Address:
  • Street:*
    City:*
  • Phone:
  • Day:
    Evening Phone:
    Cell Phone:
  • Place of Employment:
    Work Phone:
  • Family members (list age of each):
  • Primary Furniture Need:
  • Please list a secondary need in the event that their primary need is not available:
  • Statement of Need:
  • Be as specific as possible as to why you feel they are deserving. (Please give us an idea of the room size to ensure fit.)
  • Directions to Nominee’s home:
  • Submitted by:

  • Name:
  • Phone:
  • Day:
    Night:
    Cell:
  • Relationship to Nominee:
 

Click here for More Information about Miskelly's Mississippi Matters

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