Hero FAMILY Pack Request Form

To request Hero FAMILY Packs in North Carolina, please complete this form and submit to Scott Enroughty, Project Coordinator, at . Note forms should only be submitted after contacting the county 4-H agent to inform him/her about the order. Complete information about the date and location of the presentation event are required for the request to be complete. Hero FAMILY Pack Request Forms must be sent to the Project Coordinator and copied (in the same message) to the local 4-H staff member. Use this link for contact information of county 4-H staff members. These materials are ordered only upon receipt of completed request forms and typically require 6 to 8 weeks for delivery.

State:

4‐HStateMilitaryLiaison/StateOMKProjectCoordinatorande‐mail: Scott Enroughty,

StateHeroFAMILY PackPOCande‐mail: Scott Enroughty,

MilitaryUnitandBranchofServicesupportedbythisrequest:

Numberof HeroFAMILY PacksRequested:

DateNeededforPackingEvent:

AddressforshipmentofHeroFAMILY Packs: 512 Brickhaven Drive, Suite 240 Raleigh, NC 27606

PhoneNumberatShippingLocation: 919.515.8500

Branch of Service Requesting: (NC OMK’s information)

Person Requesting:

Affiliation/Branch of Service:

County:

Telephone Number:

E-mail Address:

Date of Hero FAMILY Pack Presentation:

Date Needed for Hero FAMILY Pack Assembly:

Number of Hero FAMILY Pack Requested:

Name of County 4-H Agent/Program Assistant contacted:

Ages: 2-4: 5-8: 9-10: 11-12: 13-15: 16-18:

The following information is required for the allocation of Hero FAMILY Packs:

The OMK Hero FAMILY Pack Initiative consists of three elements: an appreciation element, a content element, and a support element. Your Hero FAMILY Pack Request must address all three items.

I. Appreciation

The Hero FAMILY Pack as a whole serves as a salute and token of thanks to military families experiencing the deployment of a parent. Hero FAMILY Packs include a handwritten letter of thanks and appreciation from a local civilian youth, a collection of family support materials, communication tools, and fun items the recipient can enjoy as a family before, during and after a deployment. It is the intent of the Hero FAMILY Pack Initiative for non-military youth to hand deliver/present the backpacks to the recipients during a special presentation event.

Use the space in the box below to explain each of the following:

• How will these Hero FAMILY Packs be presented to the military families identified above? In what setting?

• What civilian youth will be involved in the presentation? How many civilian youth do you

anticipate participating?

• How will OMK Local, State and National Partners be included?

II. Content

Local civilian youth and/or community organizations solicit items including family support materials,communication tools, and fun items then assemble items into Hero FAMILY Packs.

Use the space in the box below to explain each of the following:

• How do you plan to fill the Hero FAMILY Packs with additional items? Include information on items

that address support, communication and fun; all three areas must be represented. How are items

obtained?

• What items/information do you plan to include in the Hero FAMILY Packs? Provide a list with brief

description.

Hero FAMILY PACKS:

III. Support

OMK Partners work together to create networks in communities across North Carolina to support

geographically dispersed and active duty military families. After completing the Hero FAMILY Pack

assemblyprocess it is important to spend a few minutes talking with the civilian youth and/or community organization about the importance of supporting military children and their families and discuss additional ways they may provide support personally or as a group in their community in an on-going manner.

Use the space in the box below to explain each of the following:

• Which community youth group/organization will be involved in assembling the Hero FAMILY Packs?

• How many youth and adults might participate?

• How will you incorporate the Ready, Set Go! material into the discussion? Describe the content.

• How will you incorporate the Speak Out for Military Kids material into the discussion? Describe the

content.

• How will this Hero FAMILY Pack experience build community capacity (especially local) support for

military youth?

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