LEAD Serve Others Stations
Please complete this form so that we can get an idea of how we can meet your unique needs during these trying times. Thank you so much for being members of our LEAD community. We appreciate you, and want you to know that you and your family will continue to be in our thoughts. *Supplies are limited, so please only list essential items for your immediate needs.
Parent/Guardian First and Last Name or LEAD Staff-Member Name
What is the name of your LEAD Student (s)?
What is your phone number?
LEAD Brick Church
LEAD High School
LEAD Southeast Middle School
LEAD Southeast High School
LEAD Neely's Bend
What needs do you have for your family?
Household Cleaning Products - Dishwashing Liquid, Washing Detergent, Disinfectant Wipes, Trash Bags
Toiletry Items - Toothbrush, Toothpaste, Soap, Lotion, Shampoo, Conditioner, Toilet Paper, Mouthwash
Food Items - Canned Goods, Plates, Utensils, Paper Towels, Water, Ramen Noodles
Feminine Products - Tampons, Pads, Feminine Body Wash
Snacks - Chips, Cookies, Fruit Snacks, Granola Bars
Access to Internet/Wi-Fi Capability *If you need wi-fi support, please provide additional details in the next question.
Computer Access (Chromebook)
Access to Health Care Services
Please detail your specific needs based on what is listed above in the needs section.
Explain here what specific items you saw listed above you were needing for you and your family.
Who is included in your family that you are looking to support?
Here you would include if you are looking for support for yourself, spouse, or children and list the number of people needing support.
Send me a copy of my responses.
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