Rock’n Ready School Supply Assistance Registration Form

Current Parent Information
Child 1
Child 2
Child 3
Child 4
Child 5
Release Form and Signature
Complete

Information About School-Aged Children

Please enter the information for each child COMPLETELY. Without this information, we can't gaurentee the correct supplies.

You only need to put in details about those children who are in/will be in school in Fall 2025. We are not able to provide supplies for Pre-K students.

If you have more than five children, please fill out an additional form with the names of those children.

You will receive an email confirmation if your registration is submitted. If you do not receive an email, your registration did not go through.

Name of Parent or Guardian

Telephone Number

Email Address

If no email address, input "none."
Those with an email address will receive a confirmation of registration and updates throughout the summer.

Mailing Address

City

State

ZIP Code

Total Number of Children in the Home

Total Number of children who will be in K-12 THIS FALL (2025)?

Is your total household income less than $66,000 a year?