2019 Spring Cleaning Drive Registration

 

Registration form

Is Your family in need? receive a basket of cleaning supplies! Please use this form to register for the Spring Cleaning Drive.

The deadline for registration is Mar. 10th, 2019. There is a limit of 1 basket per familY. Priority will be give to registration order while supplies last!

any questions about this program please contact arnie buehler.

E-mail: thebridgejc@gmail.com.   Phone: 607-206-1930

Name *
Name
Best Phone # *
Best Phone #