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Will County Back to School Fair 2022
Monday, July 25, 2022 (3:00pm - 6:00pm) St. Mary Immaculate Parish, 15629 South Route 59, Plainfield
The following information must be completed and submitted in order to be registered for the Will County Back to School Fair.
Why do we ask these questions? Collecting specific information about participants helps us understand who we serve and plan for the future. Catholic Charities must provide this data to our funders in order to continue providing this event. Thank you for taking the time to provide this information!
You MUST reside in Will County to participate in the Will County Back to School Fair. Do you live in Will County, Illinois?
*
Yes.
No.
Head of Household/Individual Filling Out Form (you)
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number (cell phone preferred)
*
Email
*
What is your gender?
*
Female
Male
What is your ethnicity?
*
Hispanic/Latino
Not Hispanic/Latino
What is your race? (If more than one race, please choose all that apply.)
*
American Indian/Alaska Native
Asian/Pacific Islander
Black/African American
Caucasian/White
Native Hawaiian/Other Pacific Islander
Other/Unknown
How old are you?
*
Are you a veteran?
*
Yes
No
What is the yearly income of your household?
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$16,599 and below
$16,600-18,999
$19,000-$21,349
$21,350-$24,599
$24,600-27,649
$27,650-$28,779
$28,780-$31,599
$31,600-$32,959
$32960-$35,549
$35,550-$37,139
$37,140-$39,499
$39,500-$41,319
$41,320-$42,699
$42,700-$44,249
$44,250-$45,849
$45,850-$48,999
$49,000-$50,599
$50,600-$52,149
$52,150-$55,299
$55,300-$56,899
$56,900-$63,199
$63,200-$63,249
$63,250-$68,299
$68,300-$71,149
$71,150-$73,349
$73,350-$78,399
$78,400-$78,999
$79,000-$85,399
$85,400-$91,699
$91,700-$97,999
$98,000-$104,299
$104,300 and up
Please sign below to certify that this is your true household income.
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Clear
What is your primary language?
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I understand that in order to serve as many families as possible, and to avoid duplication, the information on the application may be shared with other agencies or institutions. I give my permission to release the information contained in this application to participating churches and to other agencies offering similar Back to School Fairs. Clicking "Yes" below confirms your understanding of the above statement.
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Yes
I have reliable transportation to pick up my supplies on the day of the fair.
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Yes, I have reliable transportation.
No, I will need to find a friend to help.
How many students from your household need school supplies? (Must be entering kindergarten - 12th grade for the 2022-2023 school year.)
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How many people live in your household (including yourself)?
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Back
Next
Family Information
Thank you for entering information about yourself and your household. Please complete the next section for each person living in your household (except yourself). This includes both students and non-students.
Household Member #2 (You have already completed Household Member #1)
Name
*
First Name
Last Name
Which city/town does this individual live in?
*
Please Select
Aurora
Beecher
Bolingbrook
Braceville
Braidwood
Channahon
Coal City
Crest Hill
Crete
Diamond
Elwood
Frankfort
Godley
Homer Glen
Joliet
Lemont
Lockport
Manhattan
Minooka
Mokena
Monee
Naperville
New Lenox
Orland Park
Park Forest
Peotone
Plainfield
Rockdale
Romeoville
Shorewood
Steger
Symerton
Tinley Park
University Park
Wilmington
Woodridge
How old is this individual?
*
Is this individual a student who needs school supplies? (Must be entering grades K - 12 for the 2022-2023 school year.)
*
Yes
No
Which grade is this student entering for the 2022-2023 school year?
*
Kindergarten - 5th Grade
6th Grade - 12th Grade
Gender
*
Female
Male
What is his/her ethnicity?
*
Hispanic/Latino
Not Hispanic/Latino
What is his/her race? (If more than one race, please choose all that apply.)
*
American Indian/Alaska Native
Asian/Pacific Islander
Black/African American
Caucasian/White
Native Hawaiian/Other Pacific Islander
Other/Unknown
What is the primary language spoken by this individual?
*
Is he/she a veteran?
*
Yes
No
Household Member #3
Name
*
First Name
Last Name
Which city/town does this individual live in?
*
Please Select
Aurora
Beecher
Bolingbrook
Braceville
Braidwood
Channahon
Coal City
Crest Hill
Crete
Diamond
Elwood
Frankfort
Godley
Homer Glen
Joliet
Lemont
Lockport
Manhattan
Minooka
Mokena
Monee
Naperville
New Lenox
Orland Park
Park Forest
Peotone
Plainfield
Rockdale
Romeoville
Shorewood
Steger
Symerton
Tinley Park
University Park
Wilmington
Woodridge
How old is this individual?
*
Is this individual a student who needs school supplies? (Must be entering grades K - 12 for the 2022-2023 school year.)
*
Yes
No
Which grade is this student entering for the 2022-2023 school year?
*
Kindergarten - 5th Grade
6th Grade - 12th Grade
Gender
*
Female
Male
What is his/her ethnicity?
*
Hispanic/Latino
Not Hispanic/Latino
What is his/her race? (If more than one race, please choose all that apply.)
*
American Indian/Alaska Native
Asian/Pacific Islander
Black/African American
Caucasian/White
Native Hawaiian/Other Pacific Islander
Other/Unknown
What is the primary language spoken by this individual?
*
Is he/she a veteran?
*
Yes
No
Household Member #4
Name
*
First Name
Last Name
Which city/town does this individual live in?
*
Please Select
Aurora
Beecher
Bolingbrook
Braceville
Braidwood
Channahon
Coal City
Crest Hill
Crete
Diamond
Elwood
Frankfort
Godley
Homer Glen
Joliet
Lemont
Lockport
Manhattan
Minooka
Mokena
Monee
Naperville
New Lenox
Orland Park
Park Forest
Peotone
Plainfield
Rockdale
Romeoville
Shorewood
Steger
Symerton
Tinley Park
University Park
Wilmington
Woodridge
How old is this individual?
*
Is this individual a student who needs school supplies? (Must be entering grades K - 12 for the 2022-2023 school year.)
*
Yes
No
Which grade is this student entering for the 2022-2023 school year?
*
Kindergarten - 5th Grade
6th Grade - 12th Grade
Gender
*
Female
Male
What is his/her ethnicity?
*
Hispanic/Latino
Not Hispanic/Latino
What is his/her race? (If more than one race, please choose all that apply.)
*
American Indian/Alaska Native
Asian/Pacific Islander
Black/African American
Caucasian/White
Native Hawaiian/Other Pacific Islander
Other/Unknown
What is the primary language spoken by this individual?
*
Is he/she a veteran?
*
Yes
No
Household Member #5
Name
*
First Name
Last Name
Which city/town does this individual live in?
*
Please Select
Aurora
Beecher
Bolingbrook
Braceville
Braidwood
Channahon
Coal City
Crest Hill
Crete
Diamond
Elwood
Frankfort
Godley
Homer Glen
Joliet
Lemont
Lockport
Manhattan
Minooka
Mokena
Monee
Naperville
New Lenox
Orland Park
Park Forest
Peotone
Plainfield
Rockdale
Romeoville
Shorewood
Steger
Symerton
Tinley Park
University Park
Wilmington
Woodridge
How old is this individual?
*
Is this individual a student who needs school supplies? (Must be entering grades K - 12 for the 2022-2023 school year.)
*
Yes
No
Which grade is this student entering for the 2022-2023 school year?
*
Kindergarten - 5th Grade
6th Grade - 12th Grade
Gender
*
Female
Male
What is his/her ethnicity?
*
Hispanic/Latino
Not Hispanic/Latino
What is his/her race? (If more than one race, please choose all that apply.)
*
American Indian/Alaska Native
Asian/Pacific Islander
Black/African American
Caucasian/White
Native Hawaiian/Other Pacific Islander
Other/Unknown
What is the primary language spoken by this individual?
*
Is he/she a veteran?
*
Yes
No
Household Member #6
Name
*
First Name
Last Name
Which city/town does this individual live in?
*
Please Select
Aurora
Beecher
Bolingbrook
Braceville
Braidwood
Channahon
Coal City
Crest Hill
Crete
Diamond
Elwood
Frankfort
Godley
Homer Glen
Joliet
Lemont
Lockport
Manhattan
Minooka
Mokena
Monee
Naperville
New Lenox
Orland Park
Park Forest
Peotone
Plainfield
Rockdale
Romeoville
Shorewood
Steger
Symerton
Tinley Park
University Park
Wilmington
Woodridge
How old is this individual?
*
Is this individual a student who needs school supplies? (Must be entering grades K - 12 for the 2022-2023 school year.)
*
Yes
No
Which grade is this student entering for the 2022-2023 school year?
*
Kindergarten - 5th Grade
6th Grade - 12th Grade
Gender
*
Female
Male
What is his/her ethnicity?
*
Hispanic/Latino
Not Hispanic/Latino
What is his/her race? (If more than one race, please choose all that apply.)
*
American Indian/Alaska Native
Asian/Pacific Islander
Black/African American
Caucasian/White
Native Hawaiian/Other Pacific Islander
Other/Unknown
What is the primary language spoken by this individual?
*
Is he/she a veteran?
*
Yes
No
Household Member #7
Name
*
First Name
Last Name
Which city/town does this individual live in?
*
Please Select
Aurora
Beecher
Bolingbrook
Braceville
Braidwood
Channahon
Coal City
Crest Hill
Crete
Diamond
Elwood
Frankfort
Godley
Homer Glen
Joliet
Lemont
Lockport
Manhattan
Minooka
Mokena
Monee
Naperville
New Lenox
Orland Park
Park Forest
Peotone
Plainfield
Rockdale
Romeoville
Shorewood
Steger
Symerton
Tinley Park
University Park
Wilmington
Woodridge
How old is this individual?
*
Is this individual a student who needs school supplies? (Must be entering grades K - 12 for the 2022-2023 school year.)
*
Yes
No
Which grade is this student entering for the 2022-2023 school year?
*
Kindergarten - 5th Grade
6th Grade - 12th Grade
Gender
*
Female
Male
What is his/her ethnicity?
*
Hispanic/Latino
Not Hispanic/Latino
What is his/her race? (If more than one race, please choose all that apply.)
*
American Indian/Alaska Native
Asian/Pacific Islander
Black/African American
Caucasian/White
Native Hawaiian/Other Pacific Islander
Other/Unknown
What is the primary language spoken by this individual?
*
Is he/she a veteran?
*
Yes
No
Household Member #8
Name
*
First Name
Last Name
Which city/town does this individual live in?
*
Please Select
Aurora
Beecher
Bolingbrook
Braceville
Braidwood
Channahon
Coal City
Crest Hill
Crete
Diamond
Elwood
Frankfort
Godley
Homer Glen
Joliet
Lemont
Lockport
Manhattan
Minooka
Mokena
Monee
Naperville
New Lenox
Orland Park
Park Forest
Peotone
Plainfield
Rockdale
Romeoville
Shorewood
Steger
Symerton
Tinley Park
University Park
Wilmington
Woodridge
How old is this individual?
*
Is this individual a student who needs school supplies? (Must be entering grades K - 12 for the 2022-2023 school year.)
*
Yes
No
Which grade is this student entering for the 2022-2023 school year?
*
Kindergarten - 5th Grade
6th Grade - 12th Grade
Gender
*
Female
Male
What is his/her ethnicity?
*
Hispanic/Latino
Not Hispanic/Latino
What is his/her race? (If more than one race, please choose all that apply.)
*
American Indian/Alaska Native
Asian/Pacific Islander
Black/African American
Caucasian/White
Native Hawaiian/Other Pacific Islander
Other/Unknown
What is the primary language spoken by this individual?
*
Is he/she a veteran?
*
Yes
No
Household Member #9
Name
*
First Name
Last Name
Which city/town does this individual live in?
*
Please Select
Aurora
Beecher
Bolingbrook
Braceville
Braidwood
Channahon
Coal City
Crest Hill
Crete
Diamond
Elwood
Frankfort
Godley
Homer Glen
Joliet
Lemont
Lockport
Manhattan
Minooka
Mokena
Monee
Naperville
New Lenox
Orland Park
Park Forest
Peotone
Plainfield
Rockdale
Romeoville
Shorewood
Steger
Symerton
Tinley Park
University Park
Wilmington
Woodridge
How old is this individual?
*
Is this individual a student who needs school supplies? (Must be entering grades K - 12 for the 2022-2023 school year.)
*
Yes
No
Which grade is this student entering for the 2022-2023 school year?
*
Kindergarten - 5th Grade
6th Grade - 12th Grade
Gender
*
Female
Male
What is his/her ethnicity?
*
Hispanic/Latino
Not Hispanic/Latino
What is his/her race? (If more than one race, please choose all that apply.)
*
American Indian/Alaska Native
Asian/Pacific Islander
Black/African American
Caucasian/White
Native Hawaiian/Other Pacific Islander
Other/Unknown
What is the primary language spoken by this individual?
*
Is he/she a veteran?
*
Yes
No
Household Member #10
Name
*
First Name
Last Name
Which city/town does this individual live in?
*
Please Select
Aurora
Beecher
Bolingbrook
Braceville
Braidwood
Channahon
Coal City
Crest Hill
Crete
Diamond
Elwood
Frankfort
Godley
Homer Glen
Joliet
Lemont
Lockport
Manhattan
Minooka
Mokena
Monee
Naperville
New Lenox
Orland Park
Park Forest
Peotone
Plainfield
Rockdale
Romeoville
Shorewood
Steger
Symerton
Tinley Park
University Park
Wilmington
Woodridge
How old is this individual?
*
Is this individual a student who needs school supplies? (Must be entering grades K - 12 for the 2022-2023 school year.)
*
Yes
No
Which grade is this student entering for the 2022-2023 school year?
*
Kindergarten - 5th Grade
6th Grade - 12th Grade
Gender
*
Female
Male
What is his/her ethnicity?
*
Hispanic/Latino
Not Hispanic/Latino
What is his/her race? (If more than one race, please choose all that apply.)
*
American Indian/Alaska Native
Asian/Pacific Islander
Black/African American
Caucasian/White
Native Hawaiian/Other Pacific Islander
Other/Unknown
What is the primary language spoken by this individual?
*
Is he/she a veteran?
*
Yes
No
Submit
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