Program

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A partnership between schools, families, and Hometown Pharmacy.

Program

Registration Form In partnership with our local schools, Hometown Pharmacy’s Healthy Kids Free Vitamin Program is designed to help students stay healthy. Fill out this form and bring it into any convenient Hometown Pharmacy location along with the enclosed punch card and receive your first month’s supply of chewable multivitamins absolutely free.

Today’s Date Parent/Guardian Name Street Address City/State/Zip School District Telephone E-Mail Student’s Name Date of Birth Grade Allergies Insurance

For Store Use Only Store # Date

TheHometownPharmacies.com Ohio Locations Cornersburg 3623 S. Meridian Rd. (330) 793-4555 Columbiana 1108 Village Plaza (330) 482-9080 Struthers 655 Creed St. (330) 750-0006 Boardman-Poland 1135 W. Western Reserve Rd. (330) 629-7345 Brookfield 7160 Warren Sharon Rd. (330) 448-8009 Girard (Brine Pharmacy) 906 N. State St. (330) 545-5025

Pennsylvania Locations New Castle 20 E. Lawrence St. (724) 658-8661 Grove City 49 Pine Grove Plaza (724) 458-1900 Harmony 3 Northgate Plaza (724) 452-5334 Monongahela (Dierken’s) 100 E. Main St. (724)258-5530 Center 3589 Brodhead Rd. (724) 774-2990 Beaver 4969 Tuscarawas Rd. (724) 495-6583 New Castle Shop ‘N Save 2016 W. State St. (724) 658-9670 Greensburg 730 E. Pittsburgh St. (724) 853-3254