Supply Kit Request
After you fill out this request, Please allow 5-7 days to receive your items. If you would prefer to pick up items for faster service from PCYC, 2210 Oliver Ave N Minneapolis, MN 55411, please contact us at (612) 643-2096 or JSmith-Breedlove@pcyc-mpls.org. We will send a confirmation of your request to the email listed below.  

Note: Your scholar must be registered for Bright Futures programming to receive supplies. To register, please visit https://pcyc-mpls.org/bfregistration/
Sign in to Google to save your progress. Learn more
Is your scholar registered with Bright Futures? *
Scholar's name *
What activities do you need supplies for? *
Please enter the activity name(s)
Preferred method of receiving items *
If curbside pickup is selected you will be contacted to arrange a time.
Contact info
For delivery purposes
Your name *
Mailing Address
Email
Phone number *
Questions and comments
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy