Voucher Shopping Appointment Request Form

Clothing Voucher Referral & Appointment Request Form

NOT FOR CLIENT USE
If a family is experiencing a crisis, please call our Safe Families Hotline at (907) 277-0925 -OR- download the 907 Navigation App or visit www.alaskaimpactalliance.com/907-resource-navigations/ to access other resources available in our community.

For further questions, email boutique@beaconhillak.com

All government and private social service organizations, congregations, schools, and Beacon Hill staff are eligible to refer a family for voucher assistance.

All referrals and appointment requests must be made by eligible individuals.
Beacon Hill Boutique is available for families of 2 or more. We are no longer accepting appointments for individuals. Would you like to continue?*
Boutique Voucher Shopping Policy:
Please ensure that you and your client(s) both read, understand and agree to the below policy.
Each voucher qualifies for 10 clothing items and 4 pairs of shoes.

Punctuality:

All appointments are for a duration of 120 minutes and require a punctual arrival and departure.

If a client arrives late, 30 minutes or more, their appointment will be cancelled. The client(s) referring agent may reschedule their appointment at their discretion.

If tardiness becomes a repeated offense, (3 incidents or more), their voucher(s) will become void for a period of 6 months before rescheduling can be explored.

All appointments must be made 24 hours in advance.

All cancellations or rescheduling must take place 24 hours before your appointment is scheduled.

No-Call No-Show's:

If a client does not attend their appointment without first informing staff, it will be considered a No-Call No-Show.

If no-call-no-shows become a repeated offense, (3 incidents or more), their voucher(s) will become void for a period of 6 months before rescheduling can be explored.
The Beacon Hill Boutique's services are available for families of 2 or more people, we no longer accept appointments for individuals.

The Anchorage Gospel Rescue Mission, Catholic Social Services, or Lutheran Social Services offers emergency clothing assistance for individuals.
Is this family unable to obtain clothing, basic essentials, winter gear or additional resources through their own means?
Has this family used Boutique services before?*
Please describe the family’s immediate or emergent needs at this time
Important details, for example: living situation, loss of income, experiencing homelessness, foster care placement, ect..
If this support is not provided, what are the potential impacts on the family?*
Has this family been affected by Typhoon Halong
The Beacon Hill Boutique's service are only available to families that are unable to obtain clothing, basic essentials, winter gear or additional family resources through their own means.
Client Info:
Please list the client(s) FIRST + LAST NAMES + AGES (Children Included) *
Client Contact Number:*
Please enter a valid phone number and can receive text messages.Format: (000) 000-0000.
Client Email Address:*
example@example.com
How many children, 5 and younger are you referring?
How many elementary-aged children are you referring
How many middle and high school–aged youth are you referring
How many adults are you referring? (18 & older)
What is the nature of the placement?*
Where are they located?*
Referring Agent's Info:
What agency are you with?*
Referring Agents Full Name*

First NameLast Name
Referring Agents Contact Number:*
Please enter a valid phone number.Format: (000) 000-0000.
Referring Agents Email Address:*
example@example.com
Please select an appointment time*
Is there any other important information we may need to know?
Boutique Address:

2807 Arctic BLVD, Anchorage AK 99503; Phone Number: 907-222-0925
Should be Empty:

Clothing Voucher Referral & Appointment Request Form

Boutique Voucher Shopping Policy:

Please ensure that you and your client(s) both read, understand and agree to the below policy.

Client Info:

Referring Agent's Info:

Boutique Address: