BackPack Program Sign-up Form
Please fill out 1 form PER STUDENT!

The BackPack Program provides school-age students experiencing food insecurity enrolled in the Gorham School Department with healthy snacks and staple meal items helpful to your family for the weekend. We aim to provide food that is child-friendly, non-perishable, and easily consumed; and to distribute the weekly bag discreetly, with the help of school staff.

Food bags will be distributed TO STUDENTS while they are in school once a week. In addition, participants will receive 1 snack per day while they are at school.

If you have any questions, please email Heather at heather.whitaker@gorhamschools.org.
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Email *
Adult Name (parent/guardian/adult at home) *
Phone number *
Do we have permission to text/call you at this number? *
Physical Address (for delivery in the event of a red designation or summer programming/services).   *
Student Name *
Student School *
Grade student is entering *
Name of student's teacher (for GMS and GHS please provide advisor's name OR team name). *
If you participated in the Gorham BackPack Program in previous school years, what food item(s) did the student living in your household like the most?
If you participated in the Gorham BackPack Program in previous years, what food item(s) were NOT EATEN by the student(s) living in your household?
Is there anything else we should know?
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