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Resources Request
Please fill out information for your
oldest
student at Broken Arrow to help track requests to your family
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Email
*
Your email
Student Name
*
Your answer
(oldest) Student's Classroom Teacher
(Pre-K)
Shoop (Kindergarten)
Buck (Kindergarten)
Petzoldt (Kindergarten)
Reller (1st)
Mansour (1st)
Hager (1st)
Weber (2nd)
Stewart (2nd)
McDaniel (3rd)
Valdez/Jones (3rd)
Hays/Weakly (3rd)
Boman (4th)
Gural (4th)
Hoelting (5th)
Mathis (5th)
Melroy/Fitzgerald (5th)
Lorenz (6th)
Williamson (6th)
Langton (SLC)
Mayoral (SLC)
Greenwood (SLC)
Other:
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I would like the following items included in my next CHIPP bag or
sent home
with my child in their backpack
Dental supplies: toothpaste, toothbrushes
Hygiene hair supplies: shampoo, conditioner
Hygiene body supplies: body wash, soap, deoderent
Hat, coat, gloves, weather appropriate clothing items (specify below)
School supplies or backpack (please list needed below in last question)
Other:
I would like more
information
about...
Shoes and clothing for my child or family
Local resources for mental or physical health services
Food or other community resources for my family
Resources for my family experiencing homelessness
Programs that provide assistance with utilities and rent
Other resources (detail below)
Please list any details we need to know about your family's specific needs.
Your answer
Please let us know how many people are living in your home so that we can provide the correct amount of supplies requested
Your answer
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