School/group name:

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* 1. School/group name:

School/group mailing address:

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* 2. School/group mailing address:

City/town:

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* 3. City/town:

Postal code:

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* 4. Postal code:

Province: Nova Scotia
Name of Principal

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* 6. Name of Principal

School/group phone number:

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* 7. School/group phone number:

Primary contact person for IWALK 2016 at your school/group

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* 8. Primary contact person for IWALK 2016 at your school/group

Title of primary contact person:

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* 9. Title of primary contact person:

Primary contact person email:

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* 10. Primary contact person email:

Number of students or children/youth who will participate in the event:

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* 11. Number of students or children/youth who will participate in the event:

Grade levels:

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* 12. Grade levels:

When (what day/week) are you planning on celebrating this event?  We mainly want to know at least a week in advance to be sure you receive the stickers on time.  Tentative dates are acceptable.

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* 13. When (what day/week) are you planning on celebrating this event?  We mainly want to know at least a week in advance to be sure you receive the stickers on time.  Tentative dates are acceptable.

After completing this form, a confirmation of your registration for International Walk to School Month 2016 will be emailed to you within 1 or 2 days.

Be sure to click "Done" when you're finished entering your information. Thanks.

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