DSOSN

INDEX

School:
Contact Person:
Address:
City, State, Zip:
School Phone w/ Ext.:
Alternate Phone :
Email Address:
Preferred Method of Contact?	School Phone Alt Phone Email
Best Days and Times to Contact
We will be conducting our campaign	In the Spring (enter dates) In the Fall (enter dates) In the Winter (enter dates)
Total Number of Students
Total Number of Classrooms
Please provide coin collection containers for each classroom We will create our own coin collection containers Please provide copies of the Campaign Information Letter to Parents for each student We will download the Campaign Information Letter to Parents from your website and print our own Please provide me with a Campaign Director Kit I will download the Campaign Director Kit from your website Please provide the Teacher Information Guidelines for each classroom We will download the Teacher Information Guidelines from your website We would like a representative from DSOSN to come to our school and speak to our students about the Dimes for Down Syndrome campaign We will be conducting our campaign to honor student(s) associated with our school who are affected by Down syndrome