Adopt-A-Cell Registration Form

Please Print and Fill out this form.

Name: _______________________________________    Please make checks payable to:

SDSM&T FOUNDATION

Please mail to:

South Dakota Solar Motion Team
501 E. St Joseph Street
Rapid City, SD 57701

Address:______________________________________
E-mail (optional): ____________________________________
# of cells adopted ____ @ $25.00 each = $ ___________
_____  Check here if you would like to remain anonymous.