Belfonte Programs

SCOOP Program Enrollment

Number of students in your school?
Grade levels of students?
Planned date of your fund-raiser? (MM/DD/YYYY)
What do you plan to use the funds for?:
Will the ice cream social be used in conjunction with
another school event or activity?
If yes, what activity?
Type of school:
School Name:
School street address:
City:
State:
Zip:
Phone: Ext:
Fax:
Email:
School District:
Principal's Name:
Signature (please fax or mail in form if required):
Fund-Raiser Chairperson's Name:
Signature (please fax or mail in form if required):
Chairperson's Phone: