Back to School Bash Registration

Requirements:

Parent(s) requesting assistance MUST be currently experiencing financial hardship.
Applicant must be the parent or legal guardian of child(ren) listed below.

School supplies are being provided for children attending Pre-K through Grade 12.

Deadline to apply for free school supplies for Pre-K through high school students is Sunday, July 25, 2021. (Due to limited resources, applications received after deadline MAY be filled with supplies available.) Backpacks will be distributed @ Padgett Elementary on Saturday, July 31, 2021 @ 10am. A parent or legal guardian of the child(ren) MUST BE PRESENT to pick up supplies.

Parent/Legal Guardian's First Name *

Parent/Legal Guardian's Last Name *

Address *

City *

State *

Postal Code *

Home Phone

Cell Phone

Email Address *

Confirm Email Address *

Please list information for each child that you are registering. *

	First Name	Last Name	Age	Gender	Grade	School Name
Child #1	First Name	Last Name	Age	Gender	Grade	School Name

Please list information for each child that you are registering.

	First Name	Last Name	Age	Gender	Grade	School Name
Child #2	First Name	Last Name	Age	Gender	Grade	School Name

Please list information for each child that you are registering.

	First Name	Last Name	Age	Gender	Grade	School Name
Child #3	First Name	Last Name	Age	Gender	Grade	School Name

Please list information for each child that you are registering.

	First Name	Last Name	Age	Gender	Grade	School Name
Child #4	First Name	Last Name	Age	Gender	Grade	School Name

Please list information for each child that you are registering.

	First Name	Last Name	Age	Gender	Grade	School Name
Child #5	First Name	Last Name	Age	Gender	Grade	School Name

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