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2020-21 Donegal Power Packs Project Enrollment
The Donegal Power Packs Project is available for all children participating in classes through Donegal School District in DPS, DIS, DJH, DHS or through offered virtual instruction. The Emergency Food Assistance Program (TEFAP) "Self Declaration of Need" form will be sent to the home address provided below. once registration is received. Families meeting the income requirements need to complete and return as this needs to be received, with an original signature, to be enrolled in the program. Notification will be sent when all forms are reviewed and your student is eligible to begin receiving the weekly food pack.

Distribution of food packs will be every Thursday beginning October 1, 2020 through May 27, 2021. There is no cost to participating families. If you think your family would benefit from this program, supply the information requested below. Submit only one (1) time per family, listing all children in the household separately, indicate which student will transport the food pack, or if the family will pick up the food pack at our storage site. Students may enroll at any time during the school year, but registration is required at the beginning of each school year.

This project is a community run, non-profit program that operates strictly by volunteers. The project is hosted by The Donegal Foundation but is supported by local businesses, organizations and residents. If you would like information on helping with this project, feel free to contact us by email or telephone.

Elayne Olson, Donegal Affiliate Coordinator
(office) 717-653-4168
donegalpowerpacks@gmail.com

THE DONEGAL SCHOOL DISTRICT IS NOT SPONSORING, OFFERING OR ENDORSING THIS ACTIVITY.
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Email *
Head of Household Name *
Mailing Address *
Cell Number for Head of Household *
Will student carry home or will family pick up on Thursdays? *
Name of Student to Carry Power Pack From School *
Grade of Student Carrying Pack *
Homeroom Teacher for Student Carrying Pack
Mode of Transportation for Student Carrying Pack *
Bus
Walker
Car Rider
AM Kindergarten Pick-Up
On Thursdays
Bus Number if Applicable
Child #1 (Last, First) Name *
Child #1 DOB (00/00/0000) *
Child #1 Indicate School Attends *
Required
Child #2 (Last, First) Name (If applicable, otherwise scroll to list adults in household)
Child #2 DOB (00/00/0000)
Child #2 Indicate School Attends
Child #3 (Last, First) Name (If applicable, otherwise scroll to list adults in household)
Child #3 DOB (00/00/0000)
Child #3 Indicate School Attends
Child #4 (Last, First) Name (If applicable, otherwise scroll to list adults in household)
Child #4 DOB (00/00/0000)
Child #4 Indicate School Attends
Child #5 (Last, First) Name (If applicable, otherwise scroll to list adults in household)
Child #5 DOB (00/00/0000)
Child #5 Indicate School Attends
Child #6 (Last, First) Name (If applicable, otherwise scroll to list adults in household)
Child #6 DOB (00/00/0000)
Child #6 Indicate School Attends
Full Name of Adults in Household (18-59 yrs) *
Full Name of All Seniors in Household (60+ yrs)
Photo / Video Release *
Yes, I give my permission
No, I do NOT give my permission
I give permission for photos/videos in which my child (or ward) or I appear as a participant in tis program to be used in brochures, videos and other promotional media by the Power Packs Project:
Name of Adult Authorizing Participation *
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