School Name:

Administrators Name:

Mailing Address:

Physical Address:

Telephone: Fax:

E-mail Address:

Website:

Educator's Name:

Number of Students Per Class: Grade Level(s) / Age(s):

Subject(s) Taught: Language(s):

Primary Communication: Internet Postal

Additional Educators for Classroom Adoption Program. If more than 3 classrooms, please resubmit form.

Educator's Name 2:

Number of Students Per Class: Grade Level(s) / Age(s):

Subject(s) Taught: Language(s):

Primary Communication: Internet Postal

Educator's Name 3:

Number of Students Per Class: Grade Level(s) / Age(s):

Subject(s) Taught: Language(s):

Primary Communication: Internet Postal

I / We agree to the Classroom Adoption Program guidelines as read on the main page. Download a PDF of the guidelines.

Educators Names:
or
Administrator's Name: