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Registration for Kids to "Shop" at BLK office 2024
This form is to register a child to "shop" at the BLK office in Ellsworth, WI
by appointment
to pick-out needed winter-wear.
After submitting this form, go back to the website for instructions to see the calendar and signup
.
If you prefer to submit a request for needed items, have volunteers pick out the requested items, and coordinate pick-up in Ellsworth;
please use the appropriate online registration form at
www.BasicsForLocalKids.org
...not this form
.
One form for EACH child.
Kids ages newborn through 18 years old living in western Wisconsin are eligible.
Selection variety is based on donations. We do our best, but can not guarantee availability.
Please be patient; our BLK team has all unpaid volunteers who also keep busy with jobs and families. We look forward to helping your child stay warm and active outdoors this winter!
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* Indicates required question
Email
*
Your email
Name of Child: First and Last name
*
Your answer
City/Town child lives in
*
Your answer
County child lives in
*
Pierce County, WI
St. Croix County, WI
Other
Age
*
Your answer
Coat/Jacket Size (type N/A if not needed)
*
Your answer
Snow pants size (type N/A if not needed)
*
Your answer
Boot size (type N/A if not needed)
*
Your answer
Gloves/Mittens/Hat (type N/A if not needed)
*
Your answer
Parent / Guardian name
*
Your answer
A copy of your responses will be emailed to the address you provided.
Submit
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