Community Resource Request Form (WMIS)

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West Milwaukee Community Resource

West Milwaukee Intermediate School has a Community Resource Room available to our families/community. If at any time, one of our families or community members needs assistance with clothing, food, or school supplies, our school is there to assist. If there is a need, please complete this form and the request will be sent to Principal Thomson. From there, the request will be completed and will be made available for pick up or delivery within a 24 hour period.

Please provide the name of your WMIS student: *

Please provide the phone number to be called when request is completed. *

Are you in need of assistance with food at this time?

Yes

Clear selection

If you are in need of food assistance, please list any food allergies below:

Are you in need of assistance with school supplies?

Yes

Clear selection

What school supplies are needed? (Check all that apply)

Notebooks

Pens/pencils

Folders

Backpack

Other:

Are you requesting clothing assistance at this time?

Yes

Clear selection

Please list need clothing items including size and gender, if applicable.

Example: Mens pants size 30/30, T-shirts size S, and Shorts size M.

Would you like to meet with Ms. Anthony, West Milwaukee's Social Worker, to connect with you additional community resources?

Yes

Other:

Clear selection

Submit

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