Beyond The Bash

Student Assistance Form

This form is intended for our Partnering Agencies and the Huntington County School Corporation. If you are one of our partners, please take the time to fill out the information requested below so we can best serve your students. Thank you for taking the time to help your students and connect them with The Indiana Family Care Center! Together, we will continue to help Huntington County Residents Thrive!

If you have any questions about this form,

please call our office at 260-200-1155 ext 105

Reporting Person's First name

Reporting Person's Last name

Reporting Person's Email

Student's First Name

Student's Last Name

Student's Sex

Male

Female

Brief Description of the Student's Needs

Underwear Size (If Applicable)

Student's Shirt Size (If Applicable)

Student's Pant Size (If Applicable)

Student's Shoe Size (If Applicable)

Student's Coat Size (If Applicable)

Other Physical Item Needs