McFarland Scholar Award
Registration Form

Student’s Name: _______________________________________________ 
Paper Title: ___________________________________________________
Student’s Grade Level: __________________________________________
Student’s E-mail:_______________________________________________
Student’s Phone:_______________________________________________
Address:  _____________________________________________________

Parents Name: _________________________________________________
Parent’s E-mail: ________________________________________________
Parent’s Phone: ________________________________________________

Teacher’s Name: _______________________________________________
Teacher’s E-mail: ______________________________________________
School: _______________________________________________________

School Address: ________________________________________________

Paper Submittal:  ____Hard Copy    ____CD    ____E-mail

Please e-mail or send registration form to Kathleen Garcia by December 1, 2011.  Send via e-mail to kathleeng1951@hotmail.com or mail to 20416 N. 82nd Lane, Peoria, AZ 85301