2023 Back to School Recipient

Palatine Township Back to School Supplies Program

You must be a Palatine Township resident with children attending Kindergarten through 12^th Grade.

Submit one application per child.

Backpack(s) distribution will be held July 20, and July 21, 2023 between 9:00 AM and 3:30 PM.

Confirmation letters will be mailed by July 14, 2023 and will include details about Back to School supplies pick-up procedures. If you do not receive your letter by July 19, 2023 you must contact the Township at 847-358-6700.

AN APPLICATION SHOULD BE COMPLETED FOR EACH CHILD INDIVIDUALLY BY JUNE 30, 2023.

General Assistance Case Number

General Assistance Case Number (leave blank if not known)

Parent/ Guardian #1 First Name

Parent/ Guardian #1 Last Name

Parent/ Guardian #2 First Name

Parent/ Guardian #2 Last Name

Mailing Address

City

State

Zip Code

Phone Number

Email Address

Child's First Name

Child's Last Name

School Your Child Will be Attending Next Year (2023-2024)

Grade your child will be in next school year (2023-2024)

Pick Up Time 1st Choice

Pick Up Time 2nd Choice