Winter Coat Form

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apply for a Winter coat

To sign your child up for a free winter coat please provide us with following information.

Parent First Name

Parent Last Name

Child First Name

Child Last Name

Child Teacher's Last Name

Preferred Color (nothing guaranteed)

Child's Grade

Coat Size

Email

Address

Phone

GIVE TODAY TO HELP End Hunger

321 Washington St

Hope, IN 47246

(812) 350-2526

Thanks for submitting!

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