To sign-up for the Anaheim Ducks S.C.O.R.E. In-Class Education Kit, please complete the form below. Please indicate whether you are interested in the Ducks school supplies, Reading Is the Goal program, or both. All requests will be fulfilled based on available resources.

Teacher Name:
Email Address:
Phone Number:
Principal:
Librarian:
School Name:
Address:
City:
State:
Zip:
Number of Students:
Grade Level:	k 1 2 3 4 5 6+
What programs do you want to be enrolled in?:	Reading is the Goal School Supplies Both