Teachers Enroll

School Information

District Name *:

School Name *:

Street Address *:

City *:

State *:

Zip *:

Teacher Information

First Name *:

Last Name *:

Number of Students *:

Send Materials In ? *:

Grade You Teach:

Additional Participating Teachers at My School

Additional Teacher(s):

Salutation	First Name	Last Name	# of Student(s)	Email Address

How Can We Reach You?

Phone:

Phone Ext:

Alternate Phone:

Alternate Phone ext:

Fax Number:

Email Address

I’m going green! Please send my teacher materials digitally*

(*Digital teacher materials include: Teacher book, poster(s), teacher evaluation form,
incentive flier, state academic standards)

Teachers Enroll

School Information

Teacher Information

Additional Participating Teachers at My School

How Can We Reach You?

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