Get the free BackPack Program Referral Form - NY

Backpack Program Referral Form This form should be filled out by any teacher or staff member recommending a student for the Backpack program. The completed form should be kept in a confidential location.

How to fill out backpack program referral form

How to fill out backpack program referral form

1. To fill out the backpack program referral form, follow these steps:
2. Obtain a backpack program referral form from a participating organization or school.
3. Fill in the personal information section, including your name, address, phone number, and email.
4. Provide information about the child who needs the backpack program, including their name, age, and school they attend.
5. Indicate any specific dietary restrictions or allergies the child has.
6. Specify the pickup location or delivery preference for the backpack program.
7. Sign and date the form to indicate your agreement with the terms and conditions.
8. Submit the form to the designated contact person or organization.
9. Keep a copy of the completed referral form for your records.

Who needs backpack program referral form?

1. The backpack program referral form is needed by individuals or families who require assistance in providing meals or food supplies for their children. This form helps identify eligible recipients for the backpack program, which typically provides nutritious meals or snacks to children from low-income households or those facing food insecurity.

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What is backpack program referral form?

The backpack program referral form is a document used to refer individuals to receive backpacks filled with food and other supplies for those in need.

Who is required to file backpack program referral form?

Social workers, guidance counselors, teachers, or any other school staff member can be required to file backpack program referral form.

How to fill out backpack program referral form?

To fill out the backpack program referral form, you need to provide information about the individual in need, their contact information, and any specific dietary restrictions or preferences.

What is the purpose of backpack program referral form?

The purpose of the backpack program referral form is to ensure that individuals in need receive necessary supplies and support through the backpack program.

What information must be reported on backpack program referral form?

Information such as the individual's name, age, contact information, school or organization they are affiliated with, dietary restrictions, and any other relevant details must be reported on the backpack program referral form.