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March Clothing Store Client Registration
March - Outdoor/Indoor Clothing Store Client Registration
PLEASE NOTE: Some stores will be indoor (capped at 20 clients per shift). We will send you WGB's COVID precaution list of rules and procedures to review with your client prior to the event. You will make every effort including translation services they may need to understand. You and your client understand that if they do not abide by the list of rules, they will not be allowed entry. This events are rain or shine. Friends and family are not allowed entry with the client and children are encouraged to stay home.
I understand that the shifts are limited capacity due to Covid restrictions and I will communicate this with my client.
I certify that I am a social worker/case worker/service provider, have met with or spoken at length with the client whose information I am submitting.
I vouch that I have seen documentation from this client that allows me to verify that they are in need of assistance.
I acknowledge that I will discuss WGB's Covid precautions in detail with my client prior to the event.
Case Manager
Case Manager Name
*
Full Name (First & Last)
Case Manager Email
*
Case Manager Phone
*
Shelter/Program Name
*
Select One
A Woman's Choice
ACTS
ADAMS Center
ASPAN
Adelphi/Langley Park Family Support Center
Alexandria Community Shelter
Alexandria RHA
Alive! House
Annandale United Methodist Church (AUMC)
Arlington Community Services Board
Arlington County
Arlington County Behavorial Healthcare Division
Asian Pacific Islander Domestic Violence Resource Project (DVRP)
Ayuda
Bailey's Crossroads Transitional Housing Shelter
BARN Community Housing
Beth El House
Bethany House
Birthright of Loudoun
Brain Injury Services
Bridges to Independence
Bridging Affordability
Bright Beginnings
Britepaths
Building Futures, Inc.
Carpenter's Shelter
Carried to Full Term
CASA
Catholic Charities
Catholic Charities Prison Ministry at Diocese of Arlington
Centronia
Christ Child Society
Christian Relief Services
Christian Relief Services - Safe Places
City of Falls Church - Housing and Human Services
Clifton Park Baptist Church
Clothes For Kids
Committee for Helping Others (CHO)
Community Empowerment Northern Virginia
Community Lodgings
Community of HOPE Birth Center
Community Preservation and Development Corporation (CPDC)
Community Services Board
Community Touch, Inc.
Community Touch, Inc. - Victory Transitional Housing
Coordinated Services Planning
Cornerstones
Cornerstones ASAPP
Cornerstones Connections for Hope (C4H)
Cornerstones Embry Rucker
Cornerstones Housing Corporation
Cornerstones RestON
Courtney's House
Crescent Community
CRI - Choice Respect Independence
Crossroads Jobs
Dept. of Veteran Services - Virginia Veteran and Family Support
Deseret Employment
Development Counseling Services
Divine Mercy Care
Divine Mercy Outreach
Doorways for Women and Families
Dulles South Food Pantry
Early Head Start - Arlington
Early Head Start- Fairfax
Early Head Start- Loudoun
Easter Seal Female Veteran
Ecumenical Community Helping Others (ECHO)
Empowered Women International (EWI)
Empowerhouse
Entrusted Connections Life House (ECLH)
Epiphany Episcopal Church
Esperanza Center
Ethiopian Community Development Council (ECDC)
FACETS
FACETS - Next Steps Family Program (NSFP)
FAIR Girls
Fairfax City Dept. of Transitional Housing
Fairfax County DFS
Fairfax County DFS - Foster Care and Adoption
Fairfax County DFS - SNAPET
Fairfax County DFS - VIEW
Fairfax County DFS - WIOA Youth
Fairfax County DHCD Progress Center
Fairfax County Protection & Preservation Services
Fairfax County Public Schools
Fairfax Falls-Church CSB
Fairfax/Falls Church, South County Center
Faith Social Services
Family Pass
Far Southeast Family Strengthening Collaborative
Fauquier Family Shelter Services
FBI Victim Services
Floris United Methodist Church
For Childrens Sake
Friends of Guest House
Friendship Place
Gabriel Homes, Inc.
Gap Ministries
Gateway Homes
Generation Hope
Girls on the Run
Good Shepherd Alliance
Good Shepherd Housing
Goodwill DC RISE
Healthy Families Fairfax
Healthy Families Loudoun
Homestretch
HOPE in Northern Virginia
Human Rights Watch
Hunters Woods Fellowship House
Inmed - Healthy Families Loudoun
Inmed - Partnership for Children
INOVA
INOVA Juniper
Intensive Community Outreach Services (ICOS)
Jewish Coalition Against Domestic Abuse (JCADA)
Just A Diva Encouraging (JADE) Ministries
Just Neighbors
Kurdish Human Rights Watch (KHRW)
LINK, Inc.
Loudoun Abused Women's Shelter (LAWS)
Loudoun Cares
Loudoun County Area Agency on Aging
Loudoun County Dept. of Health- WIC
Loudoun County Dept. of Mental Health, Substance Abuse, and Developmental Services
Loudoun County Family Services
Loudoun County Homeless Prevention
Loudoun County Public Schools
Loudoun County - WIOA
Lutheran Social Service Of the National Capital Area
Manassas Baptist Church Clothing Closet
Mary House
Maryland Dept. of Human Services Food Supplement Program
Mason and Partners (MAP) Clinic
McLean Bible Church
Medical Missionaries
Melwood Jobs
Mobile Hope of Loudoun
Mosaic
N Street Village
NAMI-Northern Virginia
Naomi Project
New Hope Housing
New Hope Housing - Alexandria
New Hope Housing - Fairfax
New Light United Methodist Church
Northern Virginia Community College (NVCC)
Northern Virginia Community College (NVCC) - Dual Generations
Northern Virginia Community College (NVCC) - Financial Stability Program
Northern Virginia Community College (NVCC) - Pathway
Northern Virginia Community College (NVCC) - Working Students Success Network
Northern Virginia Family Service (NVFS)
Northern Virginia Family Service (NVFS) - Community Housing
Northern Virginia Family Service (NVFS) - Early Head Start
Northern Virginia Family Service (NVFS) - Healthy Families
Northern Virginia Family Service (NVFS) - Healthy Families
Northern Virginia Family Service (NVFS) - Multi Cultural Center
Northern Virginia Family Service (NVFS) - SERVE
Northern Virginia Family Service (NVFS) - Training Futures
Northern Virginia Human Trafficking Intiative
Northwestern Community Services
Nurturing Families
OAR
Park Valley Church
Pathway Homes, Inc.
Patrick Street Residential Intensive Care Plus
Poe Middle School
Prince George's County Dept. of Social Services
Prince William County CSB
Prince William County Government
Prince William County Public Schools
Prince William Family Services
REstart
Reston Bible Church
Reston Hospital- Parallon
Rising Hope United Methodist Church
Safe Places
Saint Gabriel’s Episcopal Church
Saint John the Apostle Roman Catholic Church
Saint Matthew's Episcopal Church
Saint Pauls Lazarus Ministry
Saint Stephen's United Methodist Church
Saint Theresa Catholic Church - Gabriel Project
Second Story
Service Source
Share Inc.
Shelter House
Shelter House - Artemis House
Shelter House - Permanent Supportive Housing
Shelter House – DVSH
Shelter House – Kate's Place
Shelter House – Katherine Hanley Family Shelter
Shelter House – Patrick Henry Family Shelter
Sister Jose Women’s Shelter
SkillSource Group, Inc
So Others Might Eat (S.O.M.E.)
Spotsylvania Virginia Dept. of Social Services
Tahirih Justice Center
The Arc of Loudoun
The Campagna Center
The Church of Jesus Christ of Latter-day Saints Development Counseling Services
The Duffy House
The Family Place
The Lamb Center
The Northwest Center
The Salvation Army
The Society of Saint Vincent de Paul
The Women's Center- DVAC
Tin Cup Fund
Together We Bake
Tree of Life Ministries
United Campus Ministries
United Community Ministries
United Healthcare - Optum
University of DC - Workforce Development
VA Medical Center- Dept. of Veterans Affairs
Victoria's Transcultural Clinical Center
Vint Hill
Virginia Dept. of Veteran Services
VOA Chesapeake - Supportive Services for Veteran Families
VOA Chesapeake – Loudoun Emergency Homeless Shelter
VOA Chesapeake – Loudoun Homeless Services Center
Wesley Housing
Western Fairfax Christian Ministries
Windy Hill Foundation
Wraparound Fairfax
Young Ladies of Tomorrow
YoungLives PG County
Youth For Tomorrow
Other
Client
To register additional clients, please submit additional forms. Adult children need their own referral. Minor children with children of their own also need to have their own referral.
Client Name (as it appears on their photo ID they will present):
*
Full Name
Client Zip Code:
*
Number of Children:
*
0
1
2
3
4
5
6
7
8 or more
Adult children need their own referral and will not be allowed to enter without one.
Which date & shift will your client attend?
*
3/13 OUTDOOR Saturday - Shift 1: 10am-10:30am
3/13 OUTDOOR Saturday - Shift 2: 11-11:30am
3/13 OUTDOOR Saturday - Shift 3: 12pm-12:30pm
3/15 INDOOR Monday - 10:00- 11:00am
3/15 INDOOR Monday - 2:00pm - 3:00pm
3/17 INDOOR Wednesday 5:00pm-6:00pm
3/20 INDOOR Saturday 9-10am
3/20 INDOOR Saturday 10:30am-11:30am
IMPORTANT: Please ensure your client can make the selected shift. Select only one please.
Comments
CAPTCHA
Bulk Order Request Form
Hi Community Distribution Partner! Please submit the form below to request a Bulk Order. The information we collect helps us with the selecting clothing for your program, mission and/or relief effort, we work with the clothing stock available at the time of the request.
Organization Name
*
Contact Person Name
*
First
Last
Email
*
Phone
*
Geographic Location(s) Served:
Loudoun County
Fairfax County
Arlington County
District of Columbia
Prince William County
Faquier County
City of Alexandria
Montgomery County
Prince George's County
Other
Please Select Best Who the Clothing Will Serve:
Disaster Relief
Homeless
Refugee Services
Domestic Violence Victims
Extreme Poverty
Human Trafficking Victims
Prison Re-entry
Overseas Mission
Low-Income Job Training
Other
Women's Clothing:
Select Season & Number of Boxes for each size (50 clothing pieces to a box)
Season
Fall/Winter
Spring/Summer
X Small (Size 0-2)
Small (Size 4-6)
Medium (Size 8-10)
Large (Size 12-14)
X Large (Size 16-18)
XX Large (Size 20+)
Scarves
Shoes
Girl's Clothing:
Select Size, Season & Number of Boxes for each size (50 clothing pieces to a box)
Season
Fall/Winter
Spring/Summer
Infant
2 to 5
6 to 8
10 to 16
Boy's Clothing:
Select Size, Season & Number of Boxes for each size (50 clothing pieces to a box)
Season
Fall/Winter
Spring/Summer
Infant
2 to 5
6 to 8
10 to 16
Teens
Men's Clothing:
Note: We do not sort men's clothing. (Boxes will have a mixture of sizes & seasons)
Number of Boxes:
Other items:
We will do our best to fill special requests of clothing type, coats & shoes but it depends on our inventory.
Other items needed:
Pick Up or Delivery:
Note: Delivery available within a 30-mile radius and depends on the availability of our volunteers.
Pick-up
Delivery
Parking Instructions
Additional Info:
Comments:
CAPTCHA
PLEASE NOTE:
As we now have store days available for clients to shop we are limiting Bag-to-Gos are for urgent need for clothing only. As always Bag-to-Gos are limited to one time per season. WGB operates in two seasons per year: Spring/Summer is April - September and Fall/Winter is October - March.
Bag-To-Go Request Form
Please submit the form below to request an EMERGENCY Bag-To-Go. Examples of an emergency are: Fleeing a DV situation, fire, flood, homelessness, being in a shelter and not having appropriate clothing Someone will contact you to schedule an appointment to pick up. Please note: this could take up to 5 business days and case managers will be responsible to picking up the bag-to-go. The information we collect helps us with the selecting clothing and styling for your client, we work with the clothing stock available at the time of the request.
Referral Source Information
Referral Case Manager
*
First
Last
Agency Name
*
Email
*
Phone
*
Anticipated Pick Up Date & Time
*
Client Information
Client Full Name
*
First
Last
Client's Zip Code
*
New or Repeating Client
*
New Client
Repeat Client
Clothing & Sizing Information
Client's Age
*
Client's Gender
*
Male
Female
Client's Height
Is the client currently working?
*
Yes
No
If yes, what industry?
Items needed (select all that apply)
*
Casual Clothing
Work Clothing
Coat
Shoes
Toiletries
Diaper size(s) (if needed):
Shirt Size:
Pants Size:
Dress Size:
Skirt Size:
Shoe Size/Color/Type: (flats, wedges, etc.)
Purse Color/Style (Tote, cross-over, etc.)
Bra Size (if needed):
Any particular characteristics? (e.g. very large bust, long legs)
Any further details that might be helpful in fulfilling request:
Reason why client needs a bag to go?
*
Recently fled DV situation w/o their belongings
Recently entered shelter and does not have clothing
Recently released from prison
Fire/flood
Other
If there is any questions about whether or not you should be submitting a Bag-to-Go request form please email, erica@womengivingback.org
Additional Family Member 1
Name
Relationship:
Age:
Gender:
Shirt Size:
Pants Size:
Dress Size:
Skirt Size:
Shoe Size:
Comments:
Additional Family Member 2
Name:
Relationship:
Age:
Gender:
Shirt Size:
Pants Size:
Dress Size:
Skirt Size:
Shoe Size:
Comments:
Additional Family Member 3
Name:
Age:
Gender:
Shirt Size:
Pants Size:
Dress Size:
Skirt Size:
Shoe Size:
Comments:
Additional Family Member 4
Name:
Relationship:
Age:
Gender:
Shirt Size:
Pants Size:
Dress Size:
Skirt Size:
Shoe Size:
Comments:
Additional Family Member 5
Name:
Relationship:
Age:
Gender:
Shirt Size:
Pants Size:
Dress Size:
Skirt Size:
Shoe Size:
Comments:
Additional Family Member 6
Name:
Relationship:
Age:
Gender:
Shirt Size:
Pants Size:
Dress Size:
Skirt Size:
Shoe Size:
Comments:
CAPTCHA
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