Thomas Jefferson School Materials Request Form
Until students are able to attend school on campus, materials will continue to be distributed every six weeks to ensure that students have everything they need to learn from home.  If your student needs additional materials prior to our school-wide distributions, please complete this form and our school staff will contact you to schedule a time for your requested item(s) to be picked up.

Thank you!
Sign in to Google to save your progress. Learn more
Student's Name: *
Student's Grade: *
Student's Teacher: *
What item(s) does your student need to continue to participate fully in Distance Learning?  Click all that apply. *
Required
If  your student needs something that is not on the list above, please write the item(s) below:
Parent's Name: *
Parent's Best Contact Information: *
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Bellflower Unified School District. Report Abuse