Strike 3 Foundation

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My Idea

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This form should be completed by an adult over the age of 18 on behalf of the participating student. Contact information submitted in this form will be used for communication purposes and will not be made available to other organizations.

Student Information
1. First Name
2. Student's Age Select Age 5 6 7 8 9 10 11 12 13 14 15 16 17 18

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School Information
3. School Name
4. Street Address
5. City
6. State Select State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
7. Zip Code

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Parent/Guardian Information
8. First Name
9. Last Name
10. Street Address
11. City
12. State Select State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
13. Zip Code
14. Phone Number
15. Email Address
16. How did you hear about Play it Foward?: Facebook Twitter Email Referred by a friend Corporate Sponsor Search Baseball Announcement Newspaper Other

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17. Project Idea (200 words or less):
    

Mission Statement

The Strike 3 Foundation heightens awareness, mobilizes support, and raises funding for childhood cancer research.

How you can help

Donate Now — Strike Out Childhood Cancer

Contact Us

Strike 3 Foundation
PO Box 191
Monroe, CT 06468

(203) 724-1067