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Shoe Application 2018

Page One

ELIGIBILITY REQUIREMENTS:
- You must pre-register and be approved to receive Back-to-School Shoes
- Must be a low-income resident of Alameda County
- Parent/Guardian must present Photo I.D.
- All students must be accompanied by a Parent/Guardian
- All shoes MUST be picked up on Saturday, September 29 by 1:00 pm
- Only 3 children per family may receive shoes. However, families with more than 3 children should check the box in Question 4. 
- You can only submit one application. If you submit more than one, your application will not be processed.
- SUBMISSION OF APPLICATION DOES NOT GUARANTEE SELECTION FOR SHOES
- APPLICATIONS MUST BE SUBMITTED NO LATER THAN FRIDAY, AUGUST 3
1. Please provide the following contact details.
This question requires a valid email address.
2. Please choose one of the following: *This question is required.
This question requires a valid number format.
4. How many children are you requesting a pair of shoes? Families are limited to 3 pairs. However, families with more than 3 children should share information on their additional children below.  *This question is required.
5. What is your annual income? *This question is required.
6. Please complete the following information for Child 1. *This question is required.
How old is your child? *This question is required.
Gender *This question is required.
Please use size chart below to determine your child's shoe size. 


  *This question is required.
7. Please complete the following information for Child 2.
How old is your child? *This question is required.
Gender *This question is required.
Please use size chart below to determine your child's shoe size.

*This question is required.
7. Please complete the following information for Child 3.
How old is your child? *This question is required.
Gender *This question is required.
Please use size chart below to determine your child's shoe size.

*This question is required.
7. Please complete the following information for Child 4, if additional shoes are available.
How old is your child? *This question is required.
Gender *This question is required.
Please use size chart below to determine your child's shoe size.

*This question is required.
7. Please complete the following information for Child 5, if additional shoes are available.
How old is your child? *This question is required.
Gender *This question is required.
Please use size chart below to determine your child's shoe size.

*This question is required.
7. Please complete the following information for Child 6, if additional shoes are available.
How old is your child? *This question is required.
Gender *This question is required.
Please use size chart below to determine your child's shoe size.

*This question is required.