Gift Receipt
Enter Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Enter Student ID
School
GHS
CCCA
MLK
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Student ID
Name
*
First Name
Last Name
Race/Ethnicity
*
African American
Hispanic
AAPI
White
Afghan/Middle Eastern
Native American
Phone Number
Format: (000) 000-0000.
Purpose
Please Select
Food Insecurity
PTS Support Circle
PTS Raffle
Client Support
Program
Gift
Please Select
Cash
Groceries
Gas
Clothing
Uber/Lyft
Other-Add Comment
Xmas 2025
Amazon
Cinamark
Dutch Bros
Fashion Nova
Nike
Starbucks
Other
$Amount
*
Comments
Please sign to certify that I have received the above mentioned amount/gift.
Please Sign
*
Staff Signature
Contact ID
Submit
Should be Empty: