Organization name
Contact person
Address
City
State
ZIP
Phone
E-mail address
Fax
Number of classrooms adopted through your participation in Humane Society Youth's Adopt-a-Classroom program
Human population of area served by your organization (check one)
less than 50,000 50,000 to 249,999
250,000 to 499,999 more than 500,000
Briefly describe the scope and nature of your efforts to start or expand your Adopt-a-Classroom program:
Yes, I would like to receive e-news updates about Humane Society Youth's programs and materials.
This form may also be printed and mailed to Humane Society Youth, KIND News 25th Anniversary Award, 67 Norwich Essex Turnpike, East Haddam, CT 06423. Entries must be received by December 31, 2008.
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