Coats for Kids Registration Form | Las Cruces Coats for Kids

Coats for Kids - 2025 Recipient Registration Form

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REGISTRATION/REGISTRACIONES

/ Name /

School/Site:

Date / La Fecha

ID#

Name of Parent or Guardian / Nombre del Padre/Madre o tutelar:

First

Last

Email / Correo Electrónico

Signature

Clear Signature

Physical or Mailing Address/Dirección de domicilio o de correo

Address Line 1

Address Line 2

City

State

Zip Code

Telephone Number/Numero de Teléfono

Child's Name

First

Last

Size / Talla

Date of Birth / Fecha de nacimiento

Gender