i-am-recycling

A NONPROFIT CORPORATION

i-am-recycling
5504 Tanglewood Pine Lane
Raleigh, NC 27610
ph: (973)970-3IAM (3426)
alt: (317)-677-2258
quintus@i-am-recycling.org

MJSA Registration

*Parent/Guardian First and Last Name:

*Child First and Last Name:

*Grade Level - Fall 2019:

*Address Line 1:

*Address Line 2:

*City:

*State/Province:

*ZIP/Postal Code:

*Country:

*Email:

*Best Phone # to Reach You:

Use this format: xxx-xxx-xxxx

Mobile Phone:

Leave blank if same as above

*Contact Preference:

Comments:

Please put any comments or special requests regarding your child here

Submit Your Message:

i-am-recycling
5504 Tanglewood Pine Lane
Raleigh, NC 27610
ph: (973)970-3IAM (3426)
alt: (317)-677-2258
quintus@i-am-recycling.org