JCS Shoe & Coat Fund Request Form

JCS Shoe & Coat Fund Request Form

Student Name:   Grade: 

School:  Date of Request: 

Item:Winter Jacket/Coat  Snow Boots  Winter hat Gloves Pants  

Shirt 

Sweater Sweatshirt/ light jacket  Sneakers  Other Shoes 

Underwear Socks 

Other (Pleas specify)

While we cannot promise to honor special request, any information about color and style preferences might be helpful in making clothing purchases. Please also feel free to give any other helpful information about the clothing request below:

CONTACT INFORMATION FOR PARENTS

Parent/Guardian name:  Phone Number: 

Email: 

 



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