The Dominic Trionfo Memorial Fund
P.O. Box 1023, Middle Island, NY 11953

Boater and Water Safety Classroom Program 2018 Order Form
*Delivery Spring 2018
For the Delivery Address, please include a person’s name.  If more than one address, please indicate each additional
address below with the corresponding quantity or indicate each address on a separate form.
Each kit includes 30 activity books, 30 parent
letters, and a teacher guide.__________________
Please complete the additional information below about how these books will be distributed.  
Please indicate grade, how many classrooms per grade, and approximately how many students per
Please contact us at
with any questions or with additional information.
Thank you for being a part of our Boater and Water Safety Program!
Please press submit after filling out this form.  Thank you.
Update:  Orders can be placed through 03/09/18.  Thank you!
If you did not submit an order prior to this date, please contact us to see if you
can still order classroom kits in 2018 or if you can be put on our list for next year.
Thank you for everyone who will be part of our program in 2018.