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Local Coat Drive
This is a form to fill out in order to receive a donated coat delivered to your door!
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* Indicates required question
First and Last Name
*
Your answer
Phone Number
*
Your answer
Street Address
*
Your answer
City
*
Forgan
Beaver
Other:
Directions to house (If in the country)
Your answer
Coat Sizes Needed
Please select all needs inside your household!
Men's Coat
XS
S
M
L
XL
XXL
Other:
Clear selection
Women's Coat
XS
S
M
L
XL
2XL
Other:
Clear selection
Boys Coats
Small
M
L
XL
Other:
Clear selection
Girls Coats
Small
M
L
XL
Other:
Clear selection
Toddler Boys Coat
2T
3T
4T
Clear selection
Toddler Girls Coat
2T
3T
4T
Clear selection
Infant Boy Coats
Newborn
3/6 Months
6/9 Months
9/12 Months
12/18 MOnths
18/24 Months
Other:
Clear selection
Infant Girls Coats
Newborn
3/6 Months
6/9 Months
9/12 Months
12/18 MOnths
18/24 Months
Other:
Clear selection
Any questions or additional needs?
Your answer
Prayer Request
Your answer
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