Winter Coat Form

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Register for Winter Coat Assistance

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 & Grade Level

Parent Phone Number

Address

Size and Prefered Coat Color (no guarentees)

321 Washington St

Hope, IN 47246

(812) 350-2526

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