Request Assistance

Know a Child in Need?

To nominate a child, please fill out and submit the form below.

All children nominated must be from a family in need due to financial situations, medical reasons, loss of parent or guardian, unemployment, or displacement. Due to the overwhelming request, only those children in the Wisconsin Dells School District are eligible. Surrounding school districts may have similar programs run through government support agencies, or non-profit organizations.

Please Note:

Only requests for our WINTER CLOTHING, EXTRA-CURRICULAR CLOTHING, and EMERGENCY ASSISTANCE programs are accepted through our website. Holiday with a Hero Program selections are made through the assistance of the Wisconsin Dells School District Staff, requests for that program are not taken through the website.

Request Assistance:

Parent/Guardian Name*
First Last
Parent/Guardian Email Address
Parent/Guardian Phone*
Parent/Guardian Secondary Phone
Parent/Guardian Physical Address*
Street Address Address Line 2 City State ZIP Code
Parent/Guardian Mailing Address is different
- Parent/Guardian Mailing Address is different
Parent/Guardian Mailing Address
Street Address Address Line 2 City State ZIP Code
Circumstances Surrounding Your Need For Assistance
Add 1 or more children to your request
Children
Child First Name*
Child Last Name*
Date of Birth*
Date Format: MM slash DD slash YYYY

Gender*
School Attending*
Current Grade*
Child residence different from parent/guardian
Child Physical Address
Street Address Address Line 2 City State ZIP Code

Child Mailing Address different
Child Mailing Address
Street Address Address Line 2 City State ZIP Code
Phone
This field is for validation purposes and should be left unchanged.

Know a Child in Need?

Please Note:

Request Assistance:

Join our Community