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Hygiene Care Package
Please complete this form to be eligible to pick-up a Girls Inc. of Chicago Hygiene Care package.
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* Indicates required question
Email
*
Your email
Parent First Name
*
Your answer
Parent Last Name
*
Your answer
Parent Phone Number
*
Your answer
Home Address (Include City, State, and Zip Code)
*
Your answer
Number of Girls Inc. Participants in the Girls Inc. Program
*
1
2
3
4
5
Other:
Girls Inc. Participant Name (Your Girl(s) name)
*
Your answer
Select the Girls Inc. Program that your girl (s) Attends
*
Bold Girls Society
Aldridge Elementary
Clay Elementary
Libby Elementary
Ruggles Elementary
Perspectives MSA
Lego League Club
Required
How old is your girl?
*
6-8
9-11
12-14
15-18
Required
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