Cares4Kids

Please complete the information below and submit the online form for consideration of enrollment into Constant Contact's Cares4Kids program. Once Constant Contact verifies your eligibility under the Cares4Kids program you will receive a complimentary Cares4Kids account for your organization's use under the Junior Achievement National Partnership with Constant Contact, subject to the terms and conditions set forth below. If your organization is not an existing user, you will be contacted with a username and password for your account.

Cares4Kids Junior Achievement Recipient Information

Are you a current user?	Yes No
Desired Existing Constant Contact User Name:
Recipient Organization:
Contact Person's First Name:
Contact Person's Last Name:
Address 1:
Address 2:
City:
State/Province:
Zip/Postal:
Country:
Phone:	(Country Code + Phone Number)
Email:
Web Site:
How the organization helps children or social development:
Email Newsletter:	Yes, send me Hints & Tips® newsletters for the products I've selected.

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