One moment please...
Name
*
First Name
Last Name
Email
*
Verify Email
*
Address
*
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Phone
*
Which of the following best describes your current life stage (please check all that apply):
Adult 22-39 years old
Adult 40-55 years old
Adult 55+
Parent of Young Children (0-9)
Parent of Tweens (10-13)
Parent of Older Children (14-21)
Empty Nester
Grandparent
Retiree
Child (0-9)
Tween (10-13)
Teen and College-Age (14-21)
Are you completing this project as part of an organization or group?
*
Yes
No
If yes, what is the name of your organization or group?
How many people in your household or group will be completing this project?
*
Where and when would you like to pick up your project supplies? Please note that these are our only times for project distribution and collection. Projects cannot be left at the front desk of The Network office or either JCC.
*
The Network Office (5750 Park Heights Ave) (October): Tuesdays from 8:30 – 9:30 a.m., 12:30 – 1:30 p.m. or 4:30 – 5:30 p.m.
The Network Office (5750 Park Heights Ave) (November): Wednesdays from 8:30 – 9:30 a.m., 12:30 – 1:30 p.m. or 4:30 – 5:30 p.m.
Owings Mills JCC: Sunday, November 17 at 10:00 – 11:00 a.m. (must order by Wednesday, November 13)
How many project bags would you like to order? Each project bag is $20.
Quantity
$20
-
Seed Planting Kits (1 project bag contains materials for 10 kits)
0
1
2
3
4
5
5
Quantity
$20
-
Kid's Oral Hygiene Kits (1 project bag contains materials for 10 kits)
0
1
2
3
4
5
6
6
Quantity
$20
-
Laundry Kits (1 project bag contains materials for 10 kits)
0
1
2
3
4
5
6
6
Quantity
$20
-
Pencil Cases (1 project bag contains materials for 10 kits)
0
1
2
3
4
5
6
6
Do you require documentation of service hours?
Yes
No
If you need documentation of service hours, please fill out
this form
to have a memo sent to you.
Comments/Questions