• 2021 Back-to-School Program

    Student Registration Form
  • EACH STUDENT MUST HAVE A SEPERATE REGISTRATION FORM COMPLETED IN ORDER TO RECEIVE SUPPLIES.

    EXAMPLE: IF YOU HAVE 5 STUDENTS, THEN YOU WILL NEED TO COMPLETE 5 SEPARATE REGISTRATION FORMS.

  • FORM INSTRUCTIONS:

    • All information on this form must be complete and accurate.
    • You must complete this form in full before July 16, 2021. You will know that you've successfully completed the form once you receive an automatic email reply.
    • You must complete a SEPARATE form for every child. You will also receive a separate submission email for each child once you've successfully submitted each form. If you have 5 students, you must complete 5 forms, and will receive 5 emails.
    • Please make sure you leave a valid email address and a good phone number in case there's a question regarding your application.
    • If you do not qualify for supplies, then you will receive a denial letter from our agency. Reasons you may be denied: significantly over poverty level, child does not live in Callaway County, child does not attend a Callaway County School.
    • Backpacks and supplies must be picked up at SERVE, Inc. between July 29th and August 4th. You will receive an email with their exact pickup day. These dates are also listed below.
    • The supplies your child will receive from SERVE, Inc. will only be a portion of what your child is expected to bring based on their school supply list provided by their school. Parents/ guardians are responsible for providing the remaining supplies.
    • All children receiving supplies must be a Callaway County resident attending a Callaway County School in grades Pre-K - 12.
  • Parent or Guardian Information: