Registration Form

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	Fax or Mail- In Wholesale Registration Form Fill in the blocks online...then print and fax or mail your registration.	Fax to ... 775.796.7523 or send by U.S. Mail to: P.O.Box 464, Shelton, CT. 06484

Please check one:

PTA

School

Not-For- Profit Organization

School Name:		District:

*OR...*
Organization Name:		Tax Exempt #:

Address:
Address 2:
City:
State:	Zip:
Contact Name:
Phone No.:		Fax No.:
Email Address:
	Give Back Program (optional) What is the Give Back Program? The Give Back Program will send your school, PTA or not- for-profit group $5 towards its fundraising efforts for each bag purchased individually at the retail price by participating members of your organization! How does it work? When sending out information to your parents, students, educators and any others wishing to participate include the Give Back number that assigns when you sign-up for our program. When ordering, the purchaser enters the Give Back code in the comment section, and will then "Give Back" $5.00 for each bag purchased at the retail price. Join the Give Back Program today - Check it off...it'll only pay!

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