ENTRY FORM - Disney
ENTRY FORM - Disney
ENTRY FORM - Disney
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<strong>ENTRY</strong> <strong>FORM</strong><br />
Please print: If the above information is incorrect, please mark changes.<br />
Teacher’s Name:<br />
School principal’s Name:<br />
Number of Students in Class:<br />
Teacher’s Email Address:<br />
Principal’s Email Address:<br />
School Phone Number:<br />
(Maximum of 50 students – one class per form)<br />
School County:<br />
If “Year-Round,” State “Off-Track” Months:<br />
Our class would like to participate in:<br />
(check one) Environmentality Pledge Only<br />
Environmentality Pledge plus Class Project<br />
Please refer to the Environmental Education Resources in the brochure. Choose up to five pamphlets from the listing and locate the<br />
number to the left of each. Circle the matching number below that corresponds to each requested pamphlet.<br />
1 2 3 4 5 6 7 8 9 10 11 12 13<br />
Return this postage-paid Entry Form (see reverse) by mail or fax to 407-855-8807.<br />
DUE DATE: Postmarked or faxed on or before November 18, 2005.<br />
For questions regarding Jiminy Cricket’s Environmentality Challenge refer to the<br />
instructions in the brochure or call toll free 1-888-JIMINYC (1-888-546-4692).<br />
By entering or being entered in Jiminy Cricket’s Environmentality Challenge, schools, students, teachers, and adult chaperones from the winning classes are consenting to the use of their<br />
names and likenesses for marketing and advertising purposes without additional compensation. The class project, including any support documents, will become the property of The State<br />
of Florida and will not be returned.
Complete form, fold here, seal with tape and return in mail.<br />
BUSINESS REPLY MAIL<br />
FIRST CLASS MAIL PERMIT NO. 5035 ORLANDO, FL<br />
POSTAGE WILL BE PAID BY ADDRESSEE<br />
NO POSTAGE<br />
NECESSARY<br />
IF MAILED<br />
IN THE<br />
UNITED STATES<br />
FULFILLMENT SERVICES<br />
JIMINY CRICKET’S<br />
ENVIRONMENTALITY CHALLENGE<br />
PO BOX 621081<br />
ORLANDO, FL 32862-9080<br />
Complete form, fold here, seal with tape and return in mail.