Registration Form 2008/09 - New Schools
Register by May 30, 2008 and your school could win one of 3 prizes of $500!
*indicates required fields
School Details:
Outlet#:
(office use only)
School Name:
*
Address:
*
City:
*
Postal Code:
*
Phone:
*
Fax:
Email:
Principal:
*
Milk Coordinator Information:
Name:
*
Phone:
*
Email:
School Profile
Name of your PAC chair for September 2008:
PAC Phone:
PAC Email:
Who is your Milk Coordinator?
Principal
Secretary
Vice Principal
Parent
Teacher
Other
Meals Coordinator
specify:
Program Information
How many students are enrolled in this school?
(# of students) *
How many students stay for lunch at your school?
(# of students) *
List your school's grade range.*
Lowest Grade:
Highest Grade:
How many classrooms are there in your school?
*
Will you have a fridge available to store milk for the Program?
Yes
No
How many times a week will you serve milk?
3
4
5
When will you serve milk?
Breakfast
Snack Time
Lunch
After School
Does your school have a school store or cafeteria for students?
School Store
Cafeteria
Neither
School Meals Program
Does your school have a Meals Program?
Yes
No
How many students participate in the Meals Program?
(# of students)
Who will be able to purchase milk at lunch?
All students
Meals students only
The following questions are to be answered for drinks that do NOT come from a vending machine and are available to students.
Product
Available
Yes
No
Student Price
White Milk 125mL
Choc Milk 125mL
White Milk 250mL
Choc Milk 250mL
White Milk 350mL
Choc Milk 350mL
Strawberry Milk 350mL
White Milk 500mL
Choc Milk 500mL
Shakes/Other flavoured Milk
100% Juice
Bottled Water
Fruit Drinks
Sport Drinks
Pop
Where will milk be sold in your school?
Milk Program
Meals Program
Vending Machine
Other
Which is the one main payment system you will use for students who buy milk? If you will be using a combination of systems, mark down the next most important one in row "b".
Main
Cash
Tickets
Card
Prepayment
Weekly
Monthly
Term
Next Most Important
Cash
Tickets
Card
Prepayment
Weekly
Monthly
Term
Getting Milk to your school
How will you milk be obtained?
Delivered
Picked up
What will be the name of your milk delivery company?
Avalon
Landmark
Blackwell
Natrel
Dairyland
Other
Island Farms
What is the brand name of the milk that will be sold in your school? (name of package)
Number of milk deliveries per week:
The following questions are to be answered only for drinks sold to students through vending machines.
Does your school have a drink vending machine(s)?
Yes
No
Who has access to the machine?
Staff only
Staff and students
What drinks does your machine supply?
Milk only
Milk plus other drinks
Other drinks only
Who supplies your vending machine accessible to students?
Yes! Please enrol our school in the ESMP.
I agree that the school is solely responsible for the planning and administration of any contest in which program items are awarded and that the BC Dairy Foundation will not be responsible for any liability, loss or damages that may result from the program. I agree that the school will make Milk available to students at lunch time, three (3) or more times per week.
I’m interested.
Please call me to explain the program in more detail.
Full Contest Rules
Any questions?
Call the Moo Crew toll-free at 1-866-582-MILK (6455).
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