Back To School – United Hmong American Association

BACK TO SCHOOL GIVEAWAY 2020

ONLINE REGISTRATION FORM

Date
Date Format: MM slash DD slash YYYY
Name*
First Last
Phone*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Name of Child or children*

Please enter each child per row. Be sure to add School Attending and Grade. Failure to provide all of the information will void your registration. Click on the + sign to add a child.

Name of Child	School Attending	Grade

CAPTCHA

Please fill out our online Registration Form. Limited quantities available; enter up to 6 children only please. Registrations will be closed once applications are filled.

Please be sure to click on the “Submit” button. Failure to fill out the required information will void your registration.

Thank you.