LIHEAP event
Please fill out this form to reserve your spot for the LIHEAP event
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
I am a parent in
*
School D68(ECC, Devonshire, Highland, Stenson, OOJH)
School D72 (Fairview South)
School D73 (East Prairie School)
School D73.5 (Meyer, Middleton< McCracken)
School D219 (Niles West, Niles North)
Skokie Resident
Other
I would like to come in at
10:00am
10:30am
11:00am
11:30am
12:00pm
12:30pm
1:00pm
1:30pm
2:00pm
2:30pm
Submit
Should be Empty: