Blast Back To School Request

Email(Required)

Parent/Guardian Name(Required)

First Last

Parent/Guardian Phone(Required)

Student Name(Required)

First Last

Student's School(Required)

If other, please list school name and location.

What difference will it make for your family to have your child(ren) receive a backpack of school supplies?(Required)

How will receiving these school supplies impact your family’s finances?(Required)

No impact, If this event didn’t exist I would still be able to purchase needed school supplies for my child(ren) and pay my bills.

A little, receiving school supplies will make it easier to pay my normal bills and stay within my budget.

A lot, I would not be able to purchase school supplies for my child(ren) and cover all of my monthly expenses.

How much do you estimate you would have needed to spend on school supplies for your child(ren) this year if this event didn’t exist?(Required)

Less than $50

$50-$100

$100-$150

$150-$200

More than $200

How much more do you estimate you will still need to spend to purchase the rest of the school supplies your child(ren) will need?(Required)

Less than $50

$50-$100

$100-$150

$150-$200

More than $200

Will receiving school supplies for your child(ren) reduce your family’s financial stress?(Required)

It will not make an impact. I would have been able to manage my current expenses without stress even without this help.

It will not make an impact. I will still have a lot of financial stress.

It will reduce my stress a little but I have outstanding bills that I’m worried about.

It will reduce my stress a lot, I will be able to manage my outstanding bills with this help.

Blast Back to School Sign-Up 2023