Organization Name *

Organization Type *

Application Type *

First Name *

Last Name *

Job Title *

Email *

Phone (Please enter a number) *

Organization Website *

What is the mission of your organization? *

What other resources do you provide children? *

How many students are enrolled at your school? (Please enter a number) *

What age does your organization serve? *

What grade levels do you serve? *

How many children from pre-k through 5th grade does your organization serve? *

How many children through 2nd grade does your organization serve? *

What percentage of students receive free and reduced meals? (Please enter a number) *

Number of coats needed (Please enter a number) *

Number of shoes needed (Please enter a number) *

Would you be able to host a 4-hour event in a gym, large space, or outdoor recreation area? *

Would you allow up to 50 volunteers inside the building to gift coats/shoes to the children? *

Does your school or organization host summer camps or recreational activities? *

Please describe the need of those you serve *

Please describe what a new coat and/or pair of shoes would mean to those you serve *

Shipping Address *

Address Two

City *

State / Province *

Zip / Postal Code *

Country *

Please select all that apply: * My organization is led by a BIPOCWe serve primarily minority childrenOur organization revenue is less than $500,000We serve vulnerable populationsNone of these apply to my organization