2019-20 Donegal Power Packs Project Registration
The Donegal Power Packs Project is available for all families living in the Donegal School District with children in DPS, DIS, DJH or DHS based on meeting income requirements. The Emergency Food Assistance Program (TEFAP) "Self Declaration of Need" form will be sent once registration is received. There is no cost to participating families.

Distribution of food packs will be at the end of the school day, every Thursday beginning October 3, 2019 through May 28, 2020 (excluding holidays on November 28, December 26 and April 9). If you think your family would benefit from this program, supply the information requested below. Submit only one (1) time per family, listing all children in the household separately, and indicate which student will transport the food pack. Students may enroll at any time during the school year, but registration is required at the beginning of each school year.

A "TEFAP" form will be sent to the home address provided below. Please complete and return as this needs to be received, with an original signature, to be enrolled in the program. Notification will be sent when all forms are reviewed and your student eligible to receive the weekly food pack.

The project is a community run, non-profit program that operates strictly by volunteers. The project is hosted by The Donegal Foundation but is supported by local businesses, organizations and residents. If you would like information on helping with this project, feel free to contact us by email or telephone.

Elayne Olson, Donegal Affiliate Coordinator
(office) 717-653-4168
donegalpowerpacks@gmail.com

THE DONEGAL SCHOOL DISTRICT IS NOT SPONSORING, OFFERING OR ENDORSING THIS ACTIVITY.
Email address *
Head of Household Name *
Your answer
Mailing Address *
Your answer
Cell Number for Head of Household *
Your answer
Name of Student Carrying Power Pack *
Your answer
Grade of Student Carrying Pack *
Your answer
Name of Homeroom Teacher for Student Carrying Pack
Your answer
Mode of Transportation for Student with Pack *
Bus
Walker
Car Rider
AM Kindergarten Pick-Up
On Thursdays
Bus Number if Applicable
Your answer
Child #1 (Last, First) Name *
Your answer
Child #1 DOB (00/00/0000) *
Your answer
Child #1 Indicate School Attends *
Required
Child #2 (Last, First) Name (If applicable, otherwise scroll to list adults in household)
Your answer
Child #2 DOB (00/00/0000)
Your answer
Child #2 Indicate School Attends
Child #3 (Last, First) Name (If applicable, otherwise scroll to list adults in household)
Your answer
Child #3 DOB (00/00/0000)
Your answer
Child #3 Indicate School Attends
Child #4 (Last, First) Name (If applicable, otherwise scroll to list adults in household)
Your answer
Child #4 DOB (00/00/0000)
Your answer
Child #4 Indicate School Attends
Child #5 (Last, First) Name (If applicable, otherwise scroll to list adults in household)
Your answer
Child #5 DOB (00/00/0000)
Your answer
Child #5 Indicate School Attends
Child #6 (Last, First) Name (If applicable, otherwise scroll to list adults in household)
Your answer
Child #6 DOB (00/00/0000)
Your answer
Child #6 Indicate School Attends
Full Name of Adults in Household (18-59 yrs) *
Your answer
Full Name of All Seniors in Household (60+ yrs)
Your answer
Photo / Video Release *
Yes, I give my permission
No, I do NOT give my permission
I give permission for photos/videos in which my child (or ward) or I appear as a participant in tis program to be used in brochures, videos and other promotional media by the Power Packs Project:
Name of Adult Authorizing Participation *
Your answer
A copy of your responses will be emailed to the address you provided.
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