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FLW Community Resource/Locker Order Form
Please fill out form the best you can. If you have any questions please call (414) 604-3416.
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Untitled Title
*Family Name
Your answer
*Phone Number and email address
Your answer
*How many people are in your immediate family?
Your answer
Do you have children at FLW? If yes, please list their names.
Your answer
Children Clothing Request
Click all that apply. You may need to scroll right to see all choices.
Boy's Small
Boy's Medium
Boy's Large
Girl's Small
Girl's Medium
Girl's Large
Short Sleeve Shirt
Long Sleeve Shirt
Sweatshirt
Hat
Gloves
Shoes
Boy's Small
Boy's Medium
Boy's Large
Girl's Small
Girl's Medium
Girl's Large
Short Sleeve Shirt
Long Sleeve Shirt
Sweatshirt
Hat
Gloves
Shoes
Clear selection
Adult Clothing Request
Click all that apply. You may need to scroll right to see all choices.
Boy's Small
Boy's Medium
Boy's Large
Girl's Small
Girl's Medium
Girls' Large
Short Sleeve Shirt
Long Sleeve Shirt
Sweatshirt
Hat
Gloves
Shoes
Boy's Small
Boy's Medium
Boy's Large
Girl's Small
Girl's Medium
Girls' Large
Short Sleeve Shirt
Long Sleeve Shirt
Sweatshirt
Hat
Gloves
Shoes
Clear selection
Please use the space below for additional comments about clothing requested.
Your answer
Food Request
Yes, we would like a package of non-perishable food.
No, a package of food is not needed at this time.
Clear selection
If yes, does your family have any allergies?
Your answer
School Supplies
Please indicate what supplies are needed. (notebooks, pencils, crayons, markers, glue, folders etc.)
Your answer
Community Resources
Are there additional family needs? We have some information for you. (counseling, weatherization, etc.)
Your answer
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