Register to receive Back-to-School Supplies

Parent's Name *

First Name

Last Name

Phone *

(###)

###

####

Child's Name *

Please fill a new form for every child separately.

First Name

Last Name

Preferred Supplies Theme

Blue

Pink

Neutral

Pick up time

Choose a time to pick up the supplies. Location: Lebrun Centre-Lions Entrance 36 Holland Ave, Bedford Enter through double glass doors under the Lions Sign. A volunteer will greet you there.

Tuesday Sept. 3 between 6-8pm

Wednesday Sept. 4 between 12-2pm

Wednesday Sept. 4 between 6-8pm