Bengalthon 2025 Student Registration – NJ Bloomfield Educational Foundation

Student Last Name *

Student First Name *

Address *

Address Line 1

City

State

Zip Code

Date *

Deadline to be eligible for individual prizes is October 11, 2024.

Select Your Student(s) School *

Select Your Student's Homeroom Teacher - BMS7

Select Your Student's Homeroom Teacher - BMS8

Select Your Student's Homeroom Teacher - BER

Select Your Student's Homeroom Teacher - BRO

Select Your Student's Homeroom Teacher - CAR

Select Your Student's Homeroom Teacher - DEM

Select Your Student's Homeroom Teacher - FAI

Select Your Student's Homeroom Teacher - FRA

Select Your Student's Homeroom Teacher - OAK

Select Your Student's Homeroom Teacher - WAT

Parent/Guardian Name *

Parent/Guardian email *

Participation Fee: *

$10.00

To make a separate donation to help support Bloomfield Schools, please enter the amount here. Thank you!

Total *

$0.00

Credit Card *

Card

Name on Card

Online Registration Form