EASTER BASKET GIVEAWAY
Please do not sign up if you are capable of providing a basket for your child. This was designed to help those who are incapable of providing their child with one this year.
CHILD NAME?
First Name
Last Name
Date Of Birth?
-
Month
-
Day
Year
Date
SEX?
Please Select
Female
Male
CHILD NAME?
First Name
Last Name
Date Of Birth?
-
Month
-
Day
Year
Date
SEX?
Please Select
Female
Male
CHILD NAME?
First Name
Last Name
Date Of Birth?
-
Month
-
Day
Year
Date
SEX?
Please Select
Female
Male
CHILD NAME?
First Name
Last Name
Date Of Birth?
-
Month
-
Day
Year
Date
SEX?
Please Select
Female
Male
City & State You Currently Reside In?
Do the child/children attend DISD?
*
Do You Currently Reside Or Grow Up In The South Dallas Community?
PARENT OR GUARDIAN NAME?
First Name
Last Name
PARENT OR GUARDIAN NUMBER(IF APPLICABLE)?
Format: (000) 000-0000.
2ND PARENT OR GUARDIAN NAME? (IF APPLICABLE)
First Name
Last Name
2ND PARENT OR GUARDIAN NUMBER? (IF APPLICABLE)
Format: (000) 000-0000.
WHAT E-MAIL SHOULD WE SEND DETAILS PERTAINING TO THIS SUBMISSION ?
example@example.com
Signature
Submit
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