Form For School Supplies - Women That Give

Parent/Guardian Information

Full Name *

Preferred Transportation concerns:

Email *

Address *

Address Line 1

City

State / Province / Region

Postal Code

Country

Phone *

Status In Canada

CHILDREN INFORMATION - Please list each child requesting support

Child's Name -1 *

School Name

Grade

Child's Name -2

School Name

Grade

Child's Name - 3

School Name

Grade

Child's Name - 4

School Name

Grade

Please add other children as needed

Include your child's name, school name and grade.

Requested School Supplies

Please check the supplies your child or children need. Support depends on available donations and campaign resources.

Pickup and Communication Details

Are you able to pick up supplies if your request is approved?

Yes
No

Best days/times to contact you:

Transportation concerns:

Accessibility needs or special instructions:

Preferred Contact: *

Phone
Text
Email

Important Notes

Support is based on availability and family need. Completing this form does not guarantee support. Families will be contacted with pickup details only if supplies are available. Please provide accurate contact information and inform Women That Give if your needs change.

Consent

I confirm that the information provided is accurate. I understand that Women That Give may contact me regarding this request and may use this information only to coordinate back-to-school support. I understand that completing this form does not guarantee that supplies will be provided.

Signature

Clear Signature

Date

Back To School Supplies Registration Form

Parent/Guardian Information

CHILDREN INFORMATION - Please list each child requesting support

Pickup and Communication Details

Important Notes

Consent