School Name:
Street Address:
City, State, Zip:
Phone:
Contact First Name:
Last Name:
Position at school:
Email:
Phone:
If there is a girl with Rett
Syndrome within your
school community,
please let us know!
Would you like us to set
up a web page for your
school?
Would you like us to
create an electronic slide
show for you to post on
your school web site or
to send via email to your
school email list?
yes
no
yes
no
Questions? Contact:
Kelly Butler, Program Director
Girl Power 2 Cure, Inc.
kelly@girlpower2cure.org
260.868.4802
