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Backpack Pickup Registration
Please complete the information below to register for backpack pickup.
For any questions please email
director@servesac.org
How many students are you registering?
*
Student 1 Information
Student First Name
*
Student Last Name
*
Grade Level
*
Parent/Guardian Contact Information
Parent/Guardian First & Last Name
*
Phone Number
*
Email Address
*
Backpack Pickup
Name of Person Picking Up Backpack
*
Relationship to Student
*
Backpack pick up time
*
A
9am
B
11am
C
12pm
Confirmation
Confirmations
*
I confirm that the information provided above is accurate.
I understand that backpack availability may be limited and submitting this form does not guarantee a backpack.
Thank you for your interest. Someone from our team will get back to you shortly!
Submit
