Pull tab Weigh-In Form

School/Organization Weigh-In Form

School/Organization/ Company Name*

Mailing Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

County where your school/organization/Company is located:*

Send the FREE Ice Cream Cone Coupons to the attention of*

Primary Contact*

Primary Contact Email*

Primary Contact Phone*

Number of Students Participating November 22nd*

Number of students/members in your school/organization*

Total Weight of Pull Tabs in Ounces*