Child ID Request Form & Information 2025

Link to Child ID webpage and informational documents:

**Click here to learn more about this program**

Scheduling:

We kindly ask that all event requests be scheduled for dates at a minimum 10 days ahead of time.

Complete this online request form, which is a requisite for each event your lodge intends to host. Upon receipt of these forms, staff will contact you to coordinate specific details and coordinate delivery and pick up of the supplies, provided we can accommodate your request.

The approval of your requests will hinge on the number of kits required for each event and available supplies.

Questions? contact Patti Nowak at 1-800-321-9357

Date of Request*

Event Information

Event Name*

Examples: Health & Safety Fair, Kindergarten Round-Up, Summer Days Festival

Sponsoring Org.*

Name of community organization requesting Child ID event ( ex. Police department, school, non profit)

Event Date*

Start Time*

Please indicate if AM or PM

End Time*

Please indicate if AM or PM

New/ Repeat*

Please indicate if this is a new event or an event in which the lodge has participated in, in the past.

Select

Event Location - Street Address, City, state, Zip*

Child ID Supplies Information

Please indicate how many of each supplies you will need, or whether you will be using leftovers from a past event.

Lodge will use left over supplies from past event:

Yes

Number of requested Child ID Supplies*

All lodges will receive each of the following:

Child ID Kit
Child ID App Flyer
Internet Safety Color Book
MI Masons Crayons

Please indicate how many your lodge will need for your event:

Delivery Method*

Please indicate how you intend to receive the supplies.

Lodge Rep will pick up in Alma

Other - see request in notes

Notes

Masonic Lodge Information

Lodge Name*

List the name of the lodge(s) conducting the Child ID activities.

Lodge #*

Lodge Contact*

Please list the name of the individual from the lodge who will serve as the contact for this event.

Lodge Contact Phone #:*

Lodge Contact Address

City

Zip

Lodge Contact Email*

Send me a copy of my responses

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