Clairz Kids, Inc. Interest Form

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Thank you for expressing interest in our organization. We appreciate your enthusiasm and would love to learn more about you and your specific needs. To help us better understand your needs and how we can best serve you, please complete the interest form below.

It's our pleasure to serve you.

Email *

501(c)(3)

Please indicate the purpose of this form: *

Clairz Kids, Inc. as a Mentor

Clairz Kids, Inc. as a Mentee

Clairz Kids, Inc. as a Volunteer

Clairz Kids, Inc. Partnership

Clairz Kids, Inc. Literacy/Intervention Programs (i.e. GED, tutoring, etc.)

Clairz Kids, Inc. Tech Program

Clairz Kids, Inc. Summer S.T.E.M Camp

Clairz Kids, Inc. Cart & Closet (Request/Donation)

Clairz Kids, Inc. Nutritional Resources (Childhood Obesity/Diabetes)

Other:

Participant's full name

Address *

Primary Contact Number *

Best time to contact *

Morning

Afternoon

Evening

Email *

Emergency Contact Information: Please include the name, relationship, and contact information (telephone number/email address) for at least one emergency contact person in case of an emergency.

Thank you for completing the interest form. Someone from our staff will contact you within 24 hours of your request/response.

Again, we appreciate you.

Sincerely,

Clairz Kids, Inc.

*If you indicated "other" above, please indicate response below.

Send me a copy of my responses.

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