Stuff the Desk Registration

August 18th & 19th at East Jr. High School

311 Lincoln St., Wisconsin Rapids, WI 54494

*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.

Registration open May 1, 2023 - August 3rd, 2023

Name of Custodial Parent
Does your family qualify for free or reduced school lunch?
Name of Person Filling Out This Form
What Time Will You Pick Up Your Supplies?
Student #1
Student Ethnicity: Hispanic or Latino Origin?
Student Race - Select all that apply:
Presently, where is the student living?
Student #2
Student Ethnicity: Hispanic or Latino Origin?
Student Race - Select all that apply:
Are you enrolled in the Wisconsin Rapids, or Nekoosa/Port Edwards Title VI: Native American Education Program?
Presently, where is the student living?
Student #3
Student Ethnicity: Hispanic or Latino Origin?
Student Race - Select all that apply:
Are you enrolled in the Wisconsin Rapids, or Nekoosa/Port Edwards Title VI: Native American Education Program?
Presently, where is the student living?
Student #4
Student Ethnicity: Hispanic or Latino Origin?
Student Race - Select all that apply:
Are you enrolled in the Wisconsin Rapids, or Nekoosa/Port Edwards Title VI: Native American Education Program?
Presently, where is the student living?
Student #5
Student Ethnicity: Hispanic or Latino Origin?
Student Race - Select all that apply:
Are you enrolled in the Wisconsin Rapids, or Nekoosa/Port Edwards Title VI: Native American Education Program?
Presently, where is the student living?
Student #6
Student Ethnicity: Hispanic or Latino Origin?
Student Race - Select all that apply:
Are you enrolled in the Wisconsin Rapids, or Nekoosa/Port Edwards Title VI: Native American Education Program?
Presently, where is the student living?
Student #7
Student Ethnicity: Hispanic or Latino Origin?
Student Race - Select all that apply:
Are you enrolled in the Wisconsin Rapids, or Nekoosa/Port Edwards Title VI: Native American Education Program?
Presently, where is the student living?
Student #8
Student Ethnicity: Hispanic or Latino Origin?
Student Race - Select all that apply:
Are you enrolled in the Wisconsin Rapids, or Nekoosa/Port Edwards Title VI: Native American Education Program?
Presently, where is the student living?
Student #9
Student Ethnicity: Hispanic or Latino Origin?
Student Race - Select all that apply:
Are you enrolled in the Wisconsin Rapids, or Nekoosa/Port Edwards Title VI: Native American Education Program?
Presently, where is the student living?
Student #10
Student Ethnicity: Hispanic or Latino Origin?
Student Race - Select all that apply:
Are you enrolled in the Wisconsin Rapids, or Nekoosa/Port Edwards Title VI: Native American Education Program?
Presently, where is the student living?
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