AUSTIN YES 2022 - 2023 Box of Dreams Project Form

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Thank you for your interest in receiving school supplies from AUSTIN YES.

This form is for elementary schools that received supplies from AUSTIN YES in 2021.

As we continue to monitor COVID-19, we will be working closely with schools to ensure the safety of students, faculty, and staff. AUSTIN YES will abide by all CDC guidelines. We are looking forward to having our staff, board members and dedicated volunteers personally distribute school supplies again this 2022 - 2023 school year.

*** If you DID NOT received supplies from AUSTIN YES for in 2021, then we invite you to fill out the 2022 - 2023 Back to Basics Project Waitlist Form.***

Our supply kits are designed to support students Kinder - 5th grade.

Please DO NOT include Pre-K or grades beyond 5th in your enrollment numbers.

Each school supply kits includes the following items: colored pencils, crayons, notebook paper, spiral notebook, big eraser, glue stick, folders with pockets, folders with pockets and brads, a ruler, pencils, ballpoint pens in black and red, and a box of tissues.

Please note that by filling out this form, it does not guarantee that you will receive supplies. If selected, you will be notified in July 2022.

For additional questions or if you are unsure which form to fill out, please email info@austinyes.org or call (210) 298-8800.

School name *

School district *

Physical address of the school *

Please include the zip code

School phone number *

Numbers only, no dashes.

School fax phone number *

Numbers only, no dashes.

Name of principal *

Principal email *

Name and title of the person requesting supplies *

Ex: Jane Smith, Sponsor Math Club

Will you be the day of contact? *

YES

If you selected NO in the previous question please enter the name and title of the person who will be the day of contact below. *

Please list n/a if this doesn't apply. This person will be contacted and sent communication leading up to the distribution day.

Email for day of contact *

Phone number for day of contact if different from school number *

Numbers only, no dashes.

First day of school *

YYYY

Number of students currently enrolled (K-5th grade only) *

Please check below that you fully understand our program *

I will communicate with my staff when supplies are expected to be delivered

I will ensure supplies will NOT be distributed to students prior to the agreed upon AUSTIN YES distribution day(s)

I will NOT inflate my enrollment numbers

I understand that if I do NOT comply with any of these rules and regulations, I could lose the opportunity to receive school supplies next year

Required

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