School Supply Assistance

	Carl Junction Bright Futures offers school supply assistance to families in financial need. If your students attend Carl Junction Schools and you need assistance, please fill out this form. If you cannot fill out this form, you may call 417-649-7026 ext 2234 to register your family for school supply assistance.

1.	Parent Last Name:*

2.	Parent First Name:*

3.	Street Address:*

4.	City:*

5.	Zip:*

6.	Phone Number:*

7.	Parent Email:*

8.	Students' Full Names and Grade Levels (for the 21-22 school year):*

9.	Did your student(s) qualify for free/reduced lunch last school year or do you expect to qualify this year?*
	--Please Select--Yes No

10.	Have you applied for free/reduced lunch for the 2021/22 school year?*
	--Please Select--YesNoI do not need to re-apply

11.	Do your students have supplies from last year they will be able to reuse for this year like backpacks, pencil boxes, scissors, clip boards, etc.? Please list supplies your student(s) will be reusing or will receive from another source.*