Warm Coat Request Form
The Norwalk Rotary will be helping provide warm coats to children in need.

Please complete this form by Friday, September 24th.

Coat distribution will take place on October 22 and 23. You will be contacted to set up a pick-up time or to make other arrangements if neither day works for you.

Questions? Char Vukovich: 515-782-1301, charvukovich@gmail.com 
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Your name (first and last) *
Cell phone with area code (we will contact you at this number regarding coat pick-up) *
Email (we will only use this to contact you with updates) *
Indicate the number(s) and size(s) of coats you are requesting. NOTE: SIZES RUN SMALL.
1
2
3
2T- GIRL
2T - BOY
3T - GIRL
3T - BOY
4- GIRL
4 - BOY
5/6 - GIRL
5/6 - BOY
7/8 - GIRL
7/8 - BOY
10/12 - GIRL
10/12 - BOY
14/16 - GIRL
14/16 - BOY
SMALL - WOMENS
SMALL - MENS
MEDIUM - WOMENS
MEDIUM - MENS
LARGE - WOMENS
LARGE - MENS
XL - WOMENS
XL - MENS
XXL - WOMENS
XXL - MENS
Use this space to provide any additional information that would help us fulfill your request. Thank you!
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