Beauregard Elementary

Return application to:

United Way of Lee County

PO Box 3075

Auburn, AL 36831

2018 SCHOOL SUPPLY APPLICATION

United Way desires for all children in Lee County to begin school with the tools to succeed. Our goal is for this program to assist families struggling to provide necessary school supplies. Applications are open to children attending school in Lee County. Applications must be received in the United Way office by July 6, 2018.  Supplies will be distributed based on need and the order in which applications are received.

If your application is accepted, you will be notified by phone call by July 25^th. Phone calls will be followed by a post card. The post card must be presented at the time of distribution. The distribution date and time will be listed on the postcard. United Way hopes to serve as many families with a demonstrated need for school supplies as possible.

Please complete both sides of application.  Thank you!

PARENT/ GUARDIAN INFORMATION (Required)

Name: ________________________________Spouse/Significant Other_________________________

Mailing Address: ____________________________________________________________

City ___________________State________Zip Code___________  Phone: ______________________

Place of Employment __________________________Spouse Place of Employment _______________

Supplies available for K-12^th grade.  Not available for Head Start, Preschool or College students.

If you do not need a backpack you may still receive the supplies just indicate so on the application.

Parent Signature __________________________   Date ________________________

STUDENT NAME & INFORMATION

Child Name: _________________________________       Entering Grade: ______________________

Age: ________________________________________       Gender:  _____________________________

School Name: _____________________________

My child needs (check one):    □ Backpack and supplies     □ Supplies only

Child Name: _________________________________       Entering Grade: ______________________

Age: ________________________________________       Gender:  _____________________________

School Name: _____________________________

My child needs (check one):    □ Backpack and supplies     □ Supplies only

Child Name: _________________________________       Entering Grade: ______________________

Age: ________________________________________       Gender:  _____________________________

School Name: _____________________________

 My child needs (check one):    □ Backpack and supplies     □ Supplies only

Child Name: _________________________________       Entering Grade: ______________________

Age: ________________________________________       Gender:  _____________________________

School Name: _____________________________

My child needs (check one):    □ Backpack and supplies     □ Supplies only

Use additional sheet if necessary to list above information.