Order Your "Stronger Than Cancer" Wristbands!
Schools that held a fundraiser to support Connecticut's Kid Governor® Megan's "Stronger Than Cancer" statewide fundraiser can complete the following form to order wristbands for participating students and teachers.

*IMPORTANT*
- Only students and teachers who have contributed $1 or more are eligible to receive a "Stronger Than Cancer" wristband.
- After your school's fundraiser, a check for the total funds raised must be made payable to "CPAN" and mailed to Connecticut's Kid Governor, 800 Main Street, Hartford, CT 06103.
- All orders must be placed (by completing this form) by Wednesday, May 23, 2018 at 5:00pm.
- Wristbands will be mailed to schools in early June once CPAN receives payment.

If you have any questions, please contact Head of Kid Governor® Brian Cofrancesco at Brian.Cofrancesco@kidgovernor.org or visit CT.KidGovernor.org/stronger-than-cancer.

Connecticut's Kid Governor® is a national award-winning statewide civics program created by the Connecticut Public Affairs Network.

Email address *
School: *
Your answer
Town/City: *
Your answer
Teacher Title: *
Teacher First Name: *
Your answer
Teacher Last Name *
Your answer
Teacher Email: *
Your answer
Teacher Phone Number: *
Your answer
Students and teachers at our school raised: *
The total $ raised by your school.
Your answer
Number of wristbands needed: *
The number of wristbands must not exceed the number of dollars raised. We ask that you request one wristband for each donor, even if some donors contributed more than $1 (unless they requested multiple wristbands). This will yield maximum funds to support hiring entertainers to visit the hospitals!
Your answer
Last Day of School *
So that we can ensure you receive your wristbands in time!
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A copy of your responses will be emailed to the address you provided.
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