Back To School Give A Way

Please complete the following form to be considered for the Kandi Cares "Back to School Give A Way." To be considered you must be a single parent and reside in Atlanta, GA & surrounding areas. Items will NOT be shipped out of state! Please only submit ONE FORM per household. You will be notified if you are selected. Due to the overwhelming amount of emails, you will only receive an email if you are selected.

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Email:*

Parent's Name:*

Phone Number:*

Child's Name:*

Gender:*

Grade:*

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