Registration Information
Parents Engaging Parents Inc. Gift With Warmth Initiative Sponsored by Senator Troy Singleton & Burlington County Commissioners will distribute new environmentally friendly winter coats to families to ensure children are prepared for the cold weather season. .
Coats for children will be given following safety guidelines by the parents, community leaders, and local non-profit partners during the giveaway.

Saturday,  December 2nd  2023 
10 am -12 pm
Burlington County Emergency Services Training Center
53 Academy Drive
Westampton, NJ 08060


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First Name/Nombre del Padre o Tutor *
Last Name/Apellido del Padre o tutor
Email/ Correo electrónico
Address/ Dirección *
City/Ciudad *
Phone number/Numero de Telefono *
What city do you reside in, and would like to register for a Free New Winter coat for your child/children?/¿En qué ciudad del condado de reside y le gustaría registrarse para obtener un abrigo de invierno nuevo y gratuito para su hijo / hijos? *
How any children are in the household/Cuantos ninos en casa? *
Please give FULL name of each child and Date of Birth, separate each name by comma Requirement)/Por favor, dé el nombre COMPLETO de cada niño y la fecha de nacimiento, separe cada nombre por coma Requisito) *
Please give the age(s) of child/children-Por favor, indique la(s) edad(es) de niño/s
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18(with school ID)
19(with school ID)
20(with school ID)
21(with school ID)
Child 1
Child 2
Child 3
Child 4
Child 5
Child 6
Child 7
Child 8
Child 9
Child 10
Clear selection
Please give birth month and year of each child receiving a coat/Por favor, dé el mes y el año de cada niño que reciba un abrigo.
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
Jan/Enero
Feb/Febrero
March/Marzo
April/Abril
May/Mayo
June/Junio
July/Julio
Aug/Agosto
Sept
Oct
Nov
Dec
Clear selection
Please give coat size of each child, (COATS RUN SMALL, remember all children MUST be present when receiving COATS, this is a Requirement)/Por favor, dé el tamaño del abrigo de cada niño, (LOS ABRIGOS CORREN PEQUENO, recuerde que todos los niños DEBEN estar presentes al recibir COATS, este es un requisito)
Boys 3T
Boys 4
Boys Size 5/6
Boys Size 7/8
Boys Size 10/12
Boys Size 14/16
Boys Size 18
Girls 3T
Girls 4
Girls Size 5/6
Girls Size 7/8
Girls Size 10/12
Girls Size 14/16
Girl Size 18
Teen/Boy Size Small
Teen/Boy Size Medium
Teen/Boy Large
Teen/Boy XL
Teen/Boy 2X
Teen/Girl Size Small
Teen Girl Size Medium
Teen Girl Size Large
Teen Girl Size XL
Teen Girl Size 2X
boy/nino
girl/nina
boy 2
girl 2
boy 3
girl 3
boy 4
girl 4
boy 5
girl 5
boy 6
girl 6
boy 7
girl 7
boy 8
girl 8
boy 9
girl 9
boy 10
girl 10
Clear selection
Is your family involved in early childhood programs? if so please list below the ones you are currently engaged with, including but not limited to, state preschool programs, Head Start, Home Visiting, SNAP, and WIC. ( Ex: Head Start, Family Success and Program for Parents)/¿Su familia está involucrada en programas para la primera infancia? si es así, enumere a continuación los programas preescolares estatales, Head Start, Visitas al hogar, SNAP y WIC. (Ej: Head Start, Family Success y Programa para Padres) *
Required
Will you be able to Pick-Up at a location in your county?/¿Podrá recoger en un lugar de su condado?
Clear selection
In weekly virtual engagements over three months, Parents Engaging Parents will actively support these 5 to 7 community's residents during this crisis by providing a safe and accessible venue to build community relationships through sharing experiences, stories, structure and actions. The weekly engagements will serve as “Health Check-Ins”, by which PEP Parent Champions will discuss how the crisis has impacted them, their families and their households. PEP Parent Champions will discuss ways to promote self-wellness for the parents, and share strategies on how to better support their children, families and community during these times. Will you be interested in continuing our relationship of engagement?/En compromisos virtuales semanales durante tres meses, Parents Engaging Parents apoyará activamente a estos 5 a 7 residentes de la comunidad durante esta crisis al proporcionar un lugar seguro y accesible para construir relaciones comunitarias a través del intercambio de experiencias, historias, estructura y acciones. Los compromisos semanales servirán como "Chequeos de Salud", mediante los cuales los Campeones de Padres de PEP discutirán cómo la crisis los ha impactado a ellos, sus familias y sus hogares. PEP Parent Champions discutirá formas de promover el auto-bienestar para los padres, y compartirá estrategias sobre cómo apoyar mejor a sus hijos, familias y comunidad durante estos tiempos. ¿Estará interesado en continuar nuestra relación de compromiso?
Clear selection
Are you interested in receiving more information about future engagements from PEPNJ and PEPNJ affiliates?/¿Está interesado en recibir más información sobre futuros compromisos de pep y afiliados de PEP? *
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