IMPORTANT: Stuff the Desk distribution will be held at East Junior High School - 311 Lincoln St. Wisconsin Rapids, WI 54494

Indicate how many students you are getting supplies for. You will enter each student's information on a separate screen.

How many people are you registering? *

(including yourself)
Fill in your registration information on this page. If you are registering additional people, you will be able to enter their registration information after you complete this page and click "Review your registration".

Stuff the Desk Registration

Parent Information

Full Name of Custodial Parent *

Relationship to student(s) *

Email Address *

Phone Number *

Street Address *

City *

State *

Zip Code *

Does your family qualify for free or reduced school lunch? *

Yes No

Presently, where is/are the student(s) living? *

with parent(s)/guardian in own home or apartment

in a shelter or temporary foster care

in a motel, car, or campsite

in transitional housing

with another family due to loss of housing or as a result of economic hardship

with friends or family members other than a parent/guardian

student living in own apartment or home

other

If other, please explain

Disclaimer
The supplies distributed at Stuff the Desk are a result of community donations and may not be all of the items requested by classrooms as teachers and school districts vary in supply requests. Please contact your student’s school if other supplies are needed. The information you have provided on this form may be shared with your student’s school district.

Name of Person filling out this form *

Student #1

First Name *

Last Name *

School Attending in the Fall of 2022 *

Grade Entering in the Fall of 2022 *

Student Ethnicity: Hispanic or Latino Origin? *

Yes No Prefer not to answer

Student Race - Select all that apply: *

Are you enrolled in the Wisconsin Rapids, or Nekoosa/Port Edwards Title VI: Native American Education Grant? *

Yes No

Additional students will be completed on subsequent screens.

Stuff the Desk 2022

IMPORTANT: Stuff the Desk distribution will be held at East Junior High School - 311 Lincoln St. Wisconsin Rapids, WI 54494

Parent Information

Student #1