Name
    Address line 1
    Address line 2
    City
    State
    Zip Code
    E-mail Address
    Please provide links to your social media handles.
    Facebook
    Instagram
    Twitter
    TikTok
    Youtube
    Are you an Delta Box subscriber?
    What is your chapter of initiation?
    What is your current chapter?
    Are you an HBCU Graduate?
    If so, please list which school(s) you attended.
    Are you a teacher?
    If so, what grade do you teach?
    If you are not a teacher, what is your occupation?
    School Information (Backpacks will be going to schools).
    Why is it important for your school to receive these backpacks?
    What is the number of students in the incoming class that you are requesting backpacks for?
    What number of backpacks are you requesting? (Maximum 35)
    School Name
    Address line 1
    Address line 2
    City
    State
    Zip Code
    School Principal Name
    Is this a Title I School?
    If selected, will you return content on gifting day (i.e., photo or video content)?