SSWB Student Application Fall 2022

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This application is for students that are in financial need to receive individualized school supplies for Fall 2022. The supply/supplies limit is $150.00. There are no age limits or grade level limits. Please give accurate information on this form for verification; if the information is not accurate, your application will be omitted. There are 7 (seven) $150 grants for school supplies available at this time. The first 7 verified applications with accurate information will be honored. We do not give money. We order the supplies and have it delivered.

Email *

Student Full Name
*

Date of Birth
*

YYYY

Address (residential)
*

Address (mailing if applicable)

Phone Number
*

School Name
*

School Address
*

School Phone Number
*

Grade Level
*

Teacher's Full Name
*

Class Name
*

Teacher's Email
*

Reason for Submitting Application
*

Needed School Supply/Supplies Not to Exceed $150
*

A copy of your responses will be emailed to the address you provided.

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