Community Partnership Registration

Thank you for forming a community connection with Newtown High School. We appreciate your generosity. We are interested in making partnerships that suit YOU best. If you would kindly fill out the form below and submit it, we will contact you shortly.
Last Name:*
First Name:
E-Mail:*
Company|Institution:
Title|Position:
Work Address: Home Address:
City City
State State
Zip Zip
Work Phone: Home Phone:
Work Fax:
Career field:
Duties:
Background:
I prefer to be contacted at: Select one: Work Home EitherBest time (if phone):
Select one: Phone Fax e-mail
Publication:Are you willing to have this information published in a booklet distributed to seniors? Yes No

(c) 2005, Frank LaBanca
Newtown High School
12 Berkshire Road
Sandy Hook, CT 06482
(203) 426-7646 fax (203) 426-6573