Registration Form - 2022
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Parent's Name *
Address *
Address
City *
City
State *
Two-character State Code (Example: SD for South Dakota)
Zip Code
5-digit Zip Code
Phone Number(s) *
E-Mail Address *
Select a shopping date *
Scheduled Shopping Time *
Enter a desired time period you wish to go shopping:
Student #1 - Name *
Enter name of student
Student #1 - Birth Date *
MM
/
DD
/
YYYY
Student #1 - Grade *
Student #1 - Sweatshirt Size *
Student #2 - Name
Enter name of student
Student #2 - Birth Date
MM
/
DD
/
YYYY
Student #2 - Grade
Student #2 - Sweatshirt Size
Student #3 - Name
Enter name of student
Student #3 - Birth Date
MM
/
DD
/
YYYY
Student #3 - Grade
Student #3 - Sweatshirt Size
Student #4 - Name
Enter name of student
Student #4 - Birth Date
MM
/
DD
/
YYYY
Student #4 - Grade
Student #4 - Sweatshirt Size
Student #5 - Name
Enter name of student
Student #5 - Birth Date
MM
/
DD
/
YYYY
Student #5 - Grade
Student #5 - Sweatshirt Size
Comments
Use this space for any comments, special requirements, circumstances, etc.
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