J. Michael Lunsford MS Family Liaison Form

CARE Network Volunteers and Assistance
JOIN THE JML CARE NETWORK: If you would like more information about how you can help, please provide your information below.
Name

First NameLast Name
Email
example@example.com
Comments:
Assistance Request: If you anticipate needing assistance of any kind this year, or know someone who does, please provide the information below.

**All information is kept strictly confidential.
I am interested in obtaining:

Weekend meals/backpack snacks sent home with my child.Hygiene items supplied to my child.Referral to clothing and/or coat events.Free or reduced lunch application.Holiday food/meals, supplied in Nov and Dec.Winter/Holiday assistance for those with a hardship.English classes.Community events and opportunities to engage.Medical, immunization, dental or mental health information.Other
Parent First NameParent Last Name
Child First NameChild Last Name
Grade
Child's Grade
Names, grades and schools of other children
Phone
Email
example@example.com
Additional information and details about your situation if you would like to share.
Brandi Adams
Family Liaison
J. Michael Lunsford Middle School
Main Office: 703-722-2660
Should be Empty:

CARE Network Volunteers and Assistance