Easter Baskets Registration Form
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Total Number of People in the Household
Number of Children in the Household
Number of Children in the Household aged Newborn to 2 Years
School District(s) Where Children Attend
Fenton School District
Linden School District
Lake Fenton School District
Are any Children on Free or Reduced Lunch Program?
Yes
No
How Did You Find Out About This Program?
Submit
Should be Empty: