This page can be printed out, completed, then either faxed or mailed to the address shown below.  Or, you can include the information requested in an e-mail to us.

If after using the CD you would feel more comfortable using a 3-ring binder version, contact the IWPCA and make that request.

 

School: 
Address: 
City, State, ZIP 
Phone: 
Fax: 
E-Mail: 
Contact Teacher: