Backpacks 2020 Backpack Registration Only
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Please fill out all required information below or you WILL NOT be able to move to the next question. Please skip any non required questions that do not pertain to you. Make sure to electronically sign and submit when you are finished or you will not be registered and will not be able to pick up your school supplies or backpack.
Email address *
PRIVACY RELEASE FORM for People to People Ministries
This form will act as your Privacy Release Form which is authorization to obtain and release of information. At the bottom of this form you will sign and submit this form and give us permission to release or exchange information with government/social agencies. This information collected will only be used to approve or deny for our Back to School Project 2020.
What are you here for today? Please check all if you are wanting to preregister for for Thanksgiving and Christmas. You will still need to schedule an appointment for those projects when the time comes. *
Did you participate in the BTS project in 2018 or 2019? *
Please check all boxes below if you have all current documentation or if a past client and you have changes please select documents have changed. *
If you were a past client do have any changes in your documentation that you need to tell us about? *
Please list any changes you have. (Address, Custody, Etc.)
Are you a client of Ohio Department ofJobs and Family Services (ODJFS)? (This means you receive food stamps, medicaid, or income from ODJFS) If you are not sure and feel you are below the 200% poverty level and want to see if you qualify please contact ODJFS, Jennifer Kearns (330)-287-5846. *
Poverty Guidelines Under 200 % Call Jennifer at JFS 330-287-5846
Total People living in your household *
How many adults (ages 19 to 59) live in your household ? *
How many Seniors (ages 60+) live in your household ? *
How many children in your custody (ages 0 - 18) live in your household? *
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