Popup form - ONGB

School Supplies for Oakland Families

We’re bringing school supplies to Oakland families for home-schooling during quarantine. If you’d like to receive school supplies fill out this form.

STUDENT REGISTRATION FORM

Fill out the form carefully for Registration

How Many Students

PARENT/GUARDIAN AND HOUSEHOLD INFORMATION.

Only the student’s parent or legal guardian may complete this section.

First Name

Last Name

Does your child qualify for free or reduced lunch?

No Yes

College Degree

No Yes

ADDRESS

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Parent E-mail

MOBILE NUMBER

Area Code

Phone Number

WORK NUMBER

Area Code

Phone Number

What is the best way to contact you?

STUDENT ACADEMIC RELEASE

By initialing here, you agree and understand that registration no way guarantees your child will win the challenge prize of $100

Initials

By initialing here, you understand that images of you or your child may be captured and you consent to ONGB/partners using this image and likeness at a later date for any purpose

Initials

By initialing here, you agree and understand that by registering for this contest, you are entering your child into the Every Day Counts Attendance Challenge (EDCAC). You further understand, only students with a completed EDCAC Application and Student Release form signed by the parent or legal guardian will be entered into the attendance challenge drawing

Initials

By initialing here, you are agreeing to share your child’s name publicly if he or she wins

Initials

By initialing here, you are agreeing for ONGB to contact you in the future about ONGB Programs.

Initials

Additional Comments