Basic Needs Support Form

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We are here to support all students and their families at the Bonneville Counseling Center. Please let us know if you are in need of basic supplies including food, clothing, hygiene products, student backpack, bedding, etc.

-Bonneville Counseling Center Staff

Email *

Student Last Name *

Student First Name *

Student Number *

Parent Last Name *

Parent Contact Phone Number *

Parent Contact Email *

Parent First Name *

Base Needs Support *

Food

Clothing (winter coat, shoes, socks, underwear, shirts, pants, etc.)

Hygiene products

Backpack

Other:

Required

Please indicate how often you would like to pick up food (weekly, monthly), clothing/shoe sizes, any other needs. *

Is there anything you would like to share with the Counseling Center to support you at this time? *

Submit

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