Boxes of Basics

One moment please...
Boxes of Basics Referral Form

142083581_2758991227655564_7071048885442085448_n.png

 

PLEASE NOTE: Due to an increase in requests, please limit your referrals to no more than 6 children per week. If you have a family with more than 6 children please contact us directly @ info@boxesofbasics.org.

Referral Contact
This section is information about the person making the referral. You will be our main point of contact. Boxes of Basics does not deliver directly to children.
*

First Name
Last Name
*

*

*

*

*

*

Address Line 1
Address Line 2
City
State/Province
ZIP/Postal Code
*
Boxes of Basics are typically ready for delivery or pick-up no later than two weeks from the request date. As we are primarily a volunteer-run organization, picking up your boxes is extremely helpful, however, if you cannot pick-up, we will arrange delivery. Boxes of Basics that are delivered to schools are dropped off at the front office.
Child 1

*

First Name
Last Name
*
*

*
*
*
*
We do our best to accommodate shoe size requests, but we can't guarantee them above a kid's size 6.
Every Box of Basics contains a seasonal wardrobe which includes outfits for school and play, underwear, socks, and pajamas. We also offer shoes, a winter coat, winter hat, and gloves to each child. Please select any of these additional items the child needs from the list above.

Special situations, particular interests, favorite colors, etc. that will help us choose the best clothing for this child.
*

Please tell us about the child's circumstances. Why are you referring this child to Boxes of Basics?
Child 2


First Name
Last Name

We do our best to accommodate shoe size requests, but we can't guarantee them above a kid's size 6.
Every Box of Basics contains a seasonal wardrobe which includes outfits for school and play, underwear, socks, and pajamas. We also offer shoes, a winter coat, and a winter hat and gloves to each child. Please select any of these additional items the child needs from the list above.

Special situations, particular interests, favorite colors, etc. that will help us choose the best clothing for this child?

Please tell us about the child's circumstances. Why are you referring this child to Boxes of Basics.
Child 3


First Name
Last Name

We do our best to accommodate shoe size requests, but we can't guarantee them above a kid's size 6.
Every Box of Basics contains a seasonal wardrobe which includes outfits for school and play, underwear, socks, and pajamas. We also offer shoes, a winter coat, winter hat, and gloves to each child. Please select any of these additional items the child needs from the list above.

Special situations, particular interests, favorite colors, etc. that will help us choose the best clothing for this child.

Please tell us about the child's circumstances. Why are you referring this child to Boxes of Basics?
Student 4


First Name
Last Name

We do our best to accommodate shoe size requests, but we can't guarantee them above a kid's size 6.
Every Box of Basics contains a seasonal wardrobe which includes outfits for school and play, underwear, socks, and pajamas. We also offer shoes, a winter coat, winter hat, and gloves to each child. Please select any of these additional items the child needs from the list above.

Special situations, particular interests, favorite colors, etc. that will help us choose the best clothing for this child?

Please tell us about the child's circumstances. Why are you referring this child to Boxes of Basics.
Student 5


First Name
Last Name

We do our best to accommodate shoe size requests, but we can't guarantee them above a kid's size 6.
Every Box of Basics contains a seasonal wardrobe which includes outfits for school and play, underwear, socks, and pajamas. We also offer shoes, a winter coat, winter hat, and gloves to each child. Please select any of these additional items the child needs from the list above.

Special situations, particular interests, favorite colors, etc. that will help us choose the best clothing for this child.

Please tell us about the child's circumstances. Why are you referring this child to Boxes of Basics?
Student 6


First Name
Last Name

We do our best to accommodate shoe size requests, but we can't guarantee them above a kid's size 6.
Every Box of Basics contains a seasonal wardrobe which includes outfits for school and play, underwear, socks, and pajamas. We also offer shoes, a winter coat, winter hat, and gloves to each child. Please select any of these additional items the child needs from the list above.

Special situations, particular interests, favorite colors, etc. that will help us choose the best clothing for this child.

Please tell us about the child's circumstances. Why are you referring this child to Boxes of Basics?