REGISTRATION FORM - 'Fill It Up' Incentives & 'Q for a Day' eligibility

Congratulations on completing the annual Popcorn Fundraiser!

This website has been designed for Popcorn Kernels & Unit Leaders to record the popcorn sales for their Unit. These figures will be used to award incentives (ex. Q For A Day, Cavaliers game, Monsters game, Indians game, etc.)

The deadline to register is December 14, 2009.

There are 2 ways to register your Scouts:

1. The preferred method is to fill out this formatted Excel Worksheet, then email it to cmanteau@cavs.com.

Note- The worksheet will open as a "Read-Only" file. Please save the worksheet to your computer under a different name. This will allow you to make modifications. This worksheet can also be found at www.theqarena.com/groups/QFADregform.xls

2. If you do not have access to Excel, you may register the Scouts by completing the survey at the bottom of this page.

ELIGIBILITY - Please register all of the Scouts in your Unit that had 5 or more customers in this year's popcorn fundraiser. (Scouts with 30+ customers are elibible for Fill It Up incentives).

If you have any questions, please contact Carl Manteau at 216-420-2141 or cmanteau@cavs.com (email preferred).

What is your Unit Type and Number (ex. Cub Scout Pack 111, Boy Scout Troop 222, etc.)

What is your Scout Council?

What is your Scout Council? Black Swamp (Findlay area)

Buckeye (Canton area)

Erie Shores (Toledo area)

Greater Cleveland

Great Trail (Akron area)

Great Western Reserve (Warren area)

Heart of Ohio (Ashland area)

Popcorn Kernel or Unit Leader Information

Popcorn Kernel or Unit Leader Information First Name:
Last Name:

Popcorn Kernel or Unit Leader Date of Birth

	MM		DD		YYYY
(Must be 18 or older)	Popcorn Kernel or Unit Leader Date of Birth (Must be 18 or older) Month	/	Day	/	Year

Popcorn Kernel or Unit Leader Contact Inforamtion

Popcorn Kernel or Unit Leader Contact Inforamtion Address:
Address 2:
City/Town:
State:
ZIP/Postal Code:
Email Address:
Phone Number:

Would you like to have all of the redemption/order forms sent directly to you (Scout Leader/Popcorn Kernal) or to each Scout?

Would you like to have all of the redemption/order forms sent directly to you (Scout Leader/Popcorn Kernal) or to each Scout? Send Directly to Scout (Parent/Guardian address must be supplied)

Send to Popcorn Kernel/Unit Leader (Scout & Parent information still required for verification purposes)

SCOUT INFORMATION

Please complete the following questions for each of your Scouts that sold popcorn to at least 5 customers. (Parent/Guardian information required)

You may enter up to eight (8) Scouts on this form. If more than 8 Scouts from your Unit qualified, please enter the first 8 Scouts and complete this form. You may then log back in as many times as necessary to enter the remaining Scouts. (Note- you can bypass this by CLICKING HERE to download a formatted Excel worksheet).

Scout #1 Information

Scout #1 Information 1.Scout First Name:
1.Scout Last Name
1.Parent/Guard. First Name:
1.Parent/Guard. Last Name:

Scout #1 Parent/Guardian Contact Information

Scout #1 Parent/Guardian Contact Information Address:
Address 2:
City/Town:
State:
ZIP/Postal Code:
Email Address:
Phone Number:

How many Popcorn Customers did Scout #1 have and what was his total sales? (information required to determine "Q for a Day" eligibility and "Fill It Up" status)

How many Popcorn Customers did Scout #1 have and what was his total sales? (information required to determine "Q for a Day" eligibility and "Fill It Up" status) # of Customers
Total Sales $

Scout #2 Information

Scout #2 Information 2.Scout First Name:
2.Scout Last Name
2.Parent/Guard. First Name:
2.Parent/Guard. Last Name:

Scout #2 Parent/Guardian Contact Information

Scout #2 Parent/Guardian Contact Information Address:
Address 2:
City/Town:
State:
ZIP/Postal Code:
Email Address:
Phone Number:

How many Popcorn Customers did Scout #2 have and what was his total sales? (information required to determine "Q for a Day" eligibility and "Fill It Up" status)

How many Popcorn Customers did Scout #2 have and what was his total sales? (information required to determine "Q for a Day" eligibility and "Fill It Up" status) # of Customers
Total Sales $

Scout #3 Information

Scout #3 Information 3.Scout First Name:
3.Scout Last Name
3.Parent/Guard. First Name:
3.Parent/Guard. Last Name:

Scout #3 Parent/Guardian Contact Information

Scout #3 Parent/Guardian Contact Information Address:
Address 2:
City/Town:
State:
ZIP/Postal Code:
Email Address:
Phone Number:

How many Popcorn Customers did Scout #3 have and what was his total sales? (information required to determine "Q for a Day" eligibility and "Fill It Up" status)

How many Popcorn Customers did Scout #3 have and what was his total sales? (information required to determine "Q for a Day" eligibility and "Fill It Up" status) # of Customers
Total Sales $

Scout #4 Information

Scout #4 Information 4.Scout First Name:
4.Scout Last Name
4.Parent/Guard. First Name:
4.Parent/Guard. Last Name:

Scout #4 Parent/Guardian Contact Information

Scout #4 Parent/Guardian Contact Information Address:
Address 2:
City/Town:
State:
ZIP/Postal Code:
Email Address:
Phone Number:

How many Popcorn Customers did Scout #4 have and what was his total sales? (information required to determine "Q for a Day" eligibility and "Fill It Up" status)

How many Popcorn Customers did Scout #4 have and what was his total sales? (information required to determine "Q for a Day" eligibility and "Fill It Up" status) # of Customers
Total Sales $

Scout #5 Information

Scout #5 Information 5.Scout First Name:
5.Scout Last Name
5.Parent/Guard. First Name:
5.Parent/Guard. Last Name:

Scout #5 Parent/Guardian Contact Information

Scout #5 Parent/Guardian Contact Information Address:
Address 2:
City/Town:
State:
ZIP/Postal Code:
Email Address:
Phone Number:

How many Popcorn Customers did Scout #5 have and what was his total sales? (information required to determine "Q for a Day" eligibility and "Fill It Up" status)

How many Popcorn Customers did Scout #5 have and what was his total sales? (information required to determine "Q for a Day" eligibility and "Fill It Up" status) # of Customers
Total Sales $

Scout #6 Information

Scout #6 Information 6.Scout First Name:
6.Scout Last Name
6.Parent/Guard. First Name:
6.Parent/Guard. Last Name:

Scout #6 Parent/Guardian Contact Information

Scout #6 Parent/Guardian Contact Information Address:
Address 2:
City/Town:
State:
ZIP/Postal Code:
Email Address:
Phone Number:

How many Popcorn Customers did Scout #6 have and what was his total sales? (information required to determine "Q for a Day" eligibility and "Fill It Up" status)

How many Popcorn Customers did Scout #6 have and what was his total sales? (information required to determine "Q for a Day" eligibility and "Fill It Up" status) # of Customers
Total Sales $

Scout #7 Information

Scout #7 Information 7.Scout First Name:
7.Scout Last Name
7.Parent/Guard. First Name:
7.Parent/Guard. Last Name:

Scout #7 Parent/Guardian Contact Information

Scout #7 Parent/Guardian Contact Information Address:
Address 2:
City/Town:
State:
ZIP/Postal Code:
Email Address:
Phone Number:

How many Popcorn Customers did Scout #7 have and what was his total sales? (information required to determine "Q for a Day" eligibility and "Fill It Up" status)

How many Popcorn Customers did Scout #7 have and what was his total sales? (information required to determine "Q for a Day" eligibility and "Fill It Up" status) # of Customers
Total Sales $

Scout #8 Information

Scout #8 Information 8.Scout First Name:
8.Scout Last Name
8.Parent/Guard. First Name:
8.Parent/Guard. Last Name:

Scout #8 Parent/Guardian Contact Information

Scout #8 Parent/Guardian Contact Information Address:
Address 2:
City/Town:
State:
ZIP/Postal Code:
Email Address:
Phone Number:

How many Popcorn Customers did Scout #8 have and what was his total sales? (information required to determine "Q for a Day" eligibility and "Fill It Up" status)

How many Popcorn Customers did Scout #8 have and what was his total sales? (information required to determine "Q for a Day" eligibility and "Fill It Up" status) # of Customers
Total Sales $