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Pennies For Patients >  Program Coordinator Resources >  Materials Order Form
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Materials Order & Dates Confirmation

Please complete this data collection form to order supplies for your Pennies campaign.  Thank you very much for your assistance. 

School Name
School Address
Zip/Postal Code
School Coordinator
Coordinator Email
Co-Coordinator Name (if applicable)
Co-Coordinator Email (if applicable)
Start Date of Pennies Campaign
End Date of Pennies Campaign

Materials Order

All materials and supplies are free of charge. Please indicate the number you would like for each of the items below. Materials will be shipped to arrive at least one month prior to your school's start date.

Classroom Collection Boxes - Usually 1 per classroom plus office and/or media center
Parent Letters - One per student in Elementary and Middle Schools
Individual Student Collection Boxes - One per student in Elementary and Middle Schools. These have shown to have a tremendous impact in schools that use them! Students and parents were more aware of and engaged in the program, and schools received record-breaking donations!
Classroom Thermometer Posters - One per classroom to help set goals and track progres
Honored Hero Poster - Local patient survivors. Help share our mission and post through your school.
Pennies Promotional Poster - Promote the campaign with this colorful poster
School Thermometer Chart - Set a goal and track your school's progress on this poster.
Paper Penny Icons (50 to a pad) - Schools sell these for $1-$5 each. Students write their name on the penny to display in school. Also great for business use!
"Collect Spare Change to Change Lives" Stickers (250 to a roll) - Reward students when they donate with a colorful sticker to wear!
Educational/Motivational DVD - This DVD is a compilation of motivational and educational videos that are appropriate for all ages. Great to play on video announcements!
Why Charlie Brown, Why? DVD - A video featuring Peanuts characters and a classmate's journey with childhood leukemia. Grades Pre-K through 6. One per school please.

Additional Ways to Have a Successful Campaign

Planning Meeting - We will meet with you and/or your student/teacher group coordinating the Pennies campaign at your school. This could also be done by phone at your convenience! (Suggest at least 1-3 months prior to the start of your campaign.)  
One on One Meeting
Student/Teacher Group Meeting
Possible dates/times
Kickoff Assembly - Kick off your Pennies campaign with a school-wide assembly led by LLS staff or volunteer. Our interactive assemblies are a combination of learning, motivation and spirit to excite your students to reach their goal!  
Yes! We'd like an assembly
Maybe. I'd like to learn more about it.
Not at this time.
If interested in an assembly, please provide potential dates and times (please list 3 for best availability - we will confirm)


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last updated on 09/20/11
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