Backpack Request
Our community is delighted to help your student with a donated backpack and available school supplies. If your student qualifies for free or reduced lunch, please complete the remainder of this form to request a backpack and basic school supplies to be delivered to your students’ school. Please submit a separate backpack request for each student.

Once you register below, backpack and basic school supplies will be distributed in 2 different ways:

1) To help your student to be ready for the first day of school register here by August 11, 2017. We will notify you by e-mail of the pick-up date and time. Pick up times will be the week of August 21 thru 25, 2017 at your students' school.

2) During the school year, backpacks and school supplies will be delivered to your student via the school counselor.

School supplies included will be based on donations and will be a basic school supply kit. Backpacks will not include all required school supplies. School supplies are donated by our community and are available while supplies last.

Date *
Parent E-mail *
Your answer
Student Last Name *
Your answer
Student First Name *
Your answer
School Attending *
Student Grade *
Parent or Guardian Requesting Supplies *
Your answer
Parent Phone Number
Your answer
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