Back-to-School Fair Registration
Please fill out one form for each student involved.

This event will be drive through only. The location of this event will be the Lacey Recreation Baseball Parking Lot. Check our "United Way of Mahaska County" Facebook Page for more updates.

Registration Deadline: Friday, July 31, 2020

This is the only day backpacks and supplies will be given out and each child MUST be pre-registered. If you are unable to make it that day, you will need to make arrangements for someone else to pick up your supplies.

Date of Event: Wednesday, August 12, 2020 | 2:30 p.m. - 6:30 p.m.
Parent(s) Name: *
Email Address: *
Cell Phone Number: *
Address: *
City: *
Student Name: *
Student School: *
Student Grade: (Going into Fall 2020) *
Student's Shoe Size
Clear selection
Is your student eligible for Free and Reduced Lunch? *
What is your Annual Income? *
Next
Never submit passwords through Google Forms.
This form was created inside of United Way of Mahaska County. Report Abuse