AGL Teen Winter Survival Kit Sign-Up

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Fill out the information below and we will put together your free Winter Survival Kit! Must be in grades 6-12 to qualify. Must be able to pick up kit from Avon Grove Library (117 Rosehill Avenue, West Grove, PA 19311). After submitting your form, the Teen Volunteer Coordinator will be in touch to let you know when your kit will be available for pickup.

Email *

Name *

For candy, do you prefer...

Chocolate

Gummies (non-sour)

Sour candy

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Any food or other allergies we should know about? (If yes, please explain below.) *

Yes

Required

What are you allergic to?

Are there any scents or flavors that you absolutely HATE? (ex. peppermint, cherry, etc.)

Do you prefer... (Pick up to 2)

Coloring

Journaling

Sketching/Drawing

Which would help you relax the most? (Pick up to 2)

A stress ball

A face mask

A bath bomb

Other thoughts or comments

Send me a copy of my responses.

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