Book It!
2011-2012 Order Form
Program Dates: October 1, 2011 - March 31, 2012
Enrolment
Deadline September 30, 2011
Book It! Reading Incentive Program K-6
This order form is for schools in the area of City of Medicine Hat
and Brooks in the province of Alberta Canada only.
All
Materials are Free!
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Contact Name: |
Position/Title: |
| School
Name: |
Street
Address: |
| City: |
Postal
Code: |
| School
Fax Number: |
School
Office Phone Number: |
| Past
Participant? Yes_______ |
No
_______ |
E-Mail
Address: |
|
Signature of Person Ordering: |
Date: |
|
I am a Book It! Backer!
I will do my best to ensure the reading award certificates are used
only to encourage reading and not sold or transferred in ways that
are against BOOK IT! guidelines. |
Signature:
Title:
Date: |
|
Each participating classroom needs one packet |
|
|
Grade
|
Total
# Classes |
Total # of Students |
| K+ |
|
|
| 1 |
|
|
| 2 |
|
|
| 3 |
|
|
| 4 |
|
|
| 5 |
|
|
| 6 |
|
|
| Total |
|
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To register for the 2011-2012 FREE Book It! program, simply fill out
the form and fax it to (403) 527-8610
or drop it off to one of the addresses below.
* Each package consists of 20 free pizza coupons per classroom for 6
months program
To print this page, go up to file>print in your browser window.
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For Medicine Hat Locations Call:
403-526-1234
1. 1277 Trans Canada Hwy. Medicine Hat, Alberta
2. #103 - 140 Maple Ave. S.E., Medicine Hat, Alberta
www.pizzahutmhat.com
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