Lampeter Strasburg School District 2020-21 Power Packs Project Enrollment Form

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Please fill this form out to enroll in Power Packs Distribution for the 20-21 school year.

We are looking forward to the fall! We acknowledge that due to COVID-19, things might look a bit differently this year. We will be as flexible and adaptable as possible, and will alert our schools and participants to any changes, if applicable.

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Name of Parent or Guardian *

Home Address *

Mobile Phone Number *

Email Address *

Race / Ethnicity of Parent or Guardian *

White

Black

Latino/a

Mixed Race

Other

Prefer not to answer

Education Level of Parent or Guardian *

Less than High School

High School Degree / GED

Some College

Associates Degree

College Degree

Graduate Degree

Choose not to answer

Name of Second Parent or Guardian

Second Parent or Guardian Mobile Number

What school does your child attend? *

How would you like to receive your Power Pack? Select only one option.

I will pick up the Power Pack each Thursday at the Lampeter Church of the Brethren

I would like the Power Pack to be sent home with my student at Lampeter Elementary

I would like the Power Pack to be sent home with my student at Hans Herr Elementary

I would like the Power Pack to be sent home with my student at Martin Meylin

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