After you fill out this order request, we will contact you with an order confirmation sheet. Please keep in mind that you have 50 points to "spend" PER SEMESTER. If there are any questions concerning the products you have received or regarding your remaining allowance for the school year please contact me at (336) 402-6651 or via email

* 1. Please type name of school.

* 2. Approximately how many children is this order going to serve?

* 3. STANDARD PRODUCTS: We will carry these items year round and keep them in full stock. Standard items include: Shampoo, pads, toothbrushes, brushes/combs, soap, deodorant, washcloths, and lotion. NOTE: each point does not equal one item. Many items come in packs.
What STANDARD items would you like to order?

  1 point 2 points 3 points 4 points 5 points
Shampoo (1 lg. or 3-5 travel size)
Pads (6 pack)
Toothbrushes (3-6 per pack)
Brushes/ Combs (2-5 per pack)
Soap (3-4 per pack)
Deodorant (1 spray or stick)
Washcloths (10-12 pack)
Lotion (1 lg or 3-4 travel size)
Toothpaste (1 lg or 3 travel size)

* 4. SPECIALTY PRODUCTS: items that are not in high demand or high quantities are not guaranteed on a weekly basis. Check this form each time before requesting a product because they will change regularly! Specialty products currently include: Body powder, Acne wash, Travel bag, Conditioner, Shaving Cream, Floss, and Mouthwash.

  1 point 2 points 3 points 4 points 5 points
Acne wash (1 bottle)
Travel bag (single bag)
Conditioner (3-6 pack)
Tissues (1 box or 3 travel size)
Shaving Cream (1 lg or 3-6 pack)
Floss (2-6 per pack)

* 5. Please type your name.

* 6. Please type Email Address.

* 7. Please leave any additional information, questions, comments or concerns.