Haircuts for Hope Kids Voucher Form

Haircuts for Hope

Family Sign-Up Form
Parent/Guardian Information

First NameLast Name
Phone Number
Please enter a valid phone number.
Email Address:
example@example.com
Child’s Information

First NameLast Name
AGEblanks field. Please add appropriate
SCHOOL DISTRICTblanks field. Please add appropriate
Is your child currently registered with the McKinney-Vento Homeless Assistance Program?

YESNONOT SUREOther
Gender(s) You Can Work With (Check all that apply):

MaleFemaleLgbtiqqOther
Hair Types You Can Work With (Check all that apply):

StraightCurlyCoilyWavyOther
Any Special Needs or Considerations? (sensory sensitivities, mobility assistance, etc.)blanks
Preferred Days You are Available To Receive Your Child's A Haircut

MondayTuesdayWednesdayThursdayFridaySaturdaySunday
Preferred Time of Day:

MorningAfternoonEvening
Additional Support

ClothingHygiene ItemsSchool SuppliesFood AssistanceHousing/Support ServicesOther
Notes or Additional Informationblanks
Consent & Signature

Consent & SignatureI understand that my child is receiving a free haircut through the Haircuts for Hope program. I give permission for trained volunteer barbers, stylists, or cosmetologists to provide this service.
Parent/Guardian Information

First NameLast Name
Signature*

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Haircuts for Hope