American Diversity Group & ESYDA Back to School Drive (Free Back Packs, School Supplies and Nutritious Food!)
American Diversity Group brings you the opportunity to secure supplies for all students, ensuring they are well equipped to succeed in the following school year!

Please complete this form BEFORE arriving! Supplies will be provided on a first come, first serve basis.
Please complete ONE form per student!

All of the information you give is protected and will NOT be disclosed to third parties.



Date and Location:

August 13th, 2022 from 10 AM- 3PM

Aastha Adult Medical Day Care
12210 Plum Orchard Drive
Ste 214
Silver Spring MD 20904
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Please enter the student's full name (Ex: Student Name) *
Please enter your full name (Ex: Parent Name)
How old is the student? *
What is student's biological sex? *
What is your phone number? (We will only use your information to contact you in the event of an emergency.) *
What is your email address? (We will only use your information to contact you in the event of an emergency.)
What is your primary residential address? (We will only use your information to contact you in the event of an emergency.) *
How did you hear about this event? *
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