Weekend Survival Kits Registration Form

If your family qualifies for free/reduced breakfasts/lunches, and you are interested in participating in the Weekend Survival Kit (WSK) program, please complete this Google Form.  You only need to complete this form once for your family.  School staff will make sure that a kit gets sent home  every two weeks with each of your children who you want to receive a kit.  Please remember there is no cost for your family to participate.  Please contact the Counselor at your child’s school if you have any questions.


Email *
Parent Name - by entering your name you are indicating that you want your child(ren) to participate in the WSK program. *
Which elementary school does your child(ren) attend? *
Full name of child #1 (ex. Sally Smith) *
What grade is child #1 in?  *
Full name of child #2 (ex. Sally Smith)
What grade is child #2 in? 
Clear selection
Full name of child #3 (ex. Sally Smith)
What grade is child #3 in? 
Clear selection
Full name of child #4 (ex. Sally Smith)
What grade is child #4 in? 
Clear selection
Full name of child #5 (ex. Sally Smith)
What grade is child #5 in? 
Clear selection
Full name of child #6 (ex. Sally Smith)
What grade is child #6 in?
Clear selection
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Howell Public Schools. Report Abuse
Google Forms