Nickels For Nails Registration

This is to be used as the registration for your school or organization to participate in the Nickels for Nails Fund-raising Drive.

If you have any questions please contact, community@habitatsect.org or 860-442-7890 ext 213 or adamico@habitatsect.org or 860-442-7890 ext 204.

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Information of School / Organization that will be participating Name:
Address:
Address 2:
City/Town:
State:
ZIP:
Email Address:
Phone Number:

Nickels For Nails Registration

Nickels For Nails Registration

*
Information of School / Organization that will be participating

Grade Level

*
Adult Leader Information
(there must be an adult from the school or organization that is willing to be the primary contact person for the event)

Adult Leader's Position

Student Leader Information

Student Leader Information

What year will you being doing the drive?

How do you plan to run the drive in your school, congregation or community?

Adult Leader Information (there must be an adult from the school or organization that is willing to be the primary contact person for the event) Name:
Email Address:
Phone Number:

Nickels For Nails Registration

Nickels For Nails Registration

*Information of School / Organization that will be participating

Grade Level

*Adult Leader Information (there must be an adult from the school or organization that is willing to be the primary contact person for the event)

Adult Leader's Position

Student Leader Information

Student Leader Information

What year will you being doing the drive?

How do you plan to run the drive in your school, congregation or community?

*
Information of School / Organization that will be participating

*
Adult Leader Information
(there must be an adult from the school or organization that is willing to be the primary contact person for the event)