Municipality of Anchorage (MOA) Wellness Kit Giveaway Application
Personal Information
First Name:
Last Name:
Email Address:
Phone Number:
Program Name:
Program Address:
Licensing Type:
Application Questions
Did your program receive a wellness kit last fall?
Yes
No
Is your program in the Municipality of Anchorage?
Yes
No
Are you part of the Alaska SEED Registry?
Yes
No
Do you have an account with thread's ServicePortal?
Yes
No
Do you want to receive updates and news from thread via email and text?
Yes, please!
No, thank you
Acknowledgement
By checking this box, I confirm that these wellness kits are intended solely for programs within the Municipality of Anchorage and that my program is located within this area. I understand that availability is limited, and preference will be given to providers who have not previously received a wellness kit. Additionally, I acknowledge that if selected to receive a wellness kit, I must pick it up at the designated time; otherwise, the kit will be offered to the next eligible provider.