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Educational Program Resources Questionnaire
Educational Program Resources Questionnaire
1.
Contact Info:
*
Name:
Title
First
Required
Last
Required
Mr.
Ms.
Mrs.
Miss
Dr.
Required
*
Email:
Required
Yes, I would like to receive e-mail from Sustainable Food Center
*
2.
Question - Required -
Which best describes your position?
Please select response
Teacher
Afterschool/Enrichment Program Leader
Nonprofit/Community Organization Employee
Parent Volunteer
Community Volunteer
School District Employee
Other
3.
Question - Not Required -
If you selected Other above, please specify here:
*
4.
Question - Required -
Name of school where resources will be used. If used in multiple schools, district-wide, or at non-campus setting, please describe:
(Maximum response 255 chars, approx. 5 rows of text)
*
5.
Question - Required -
Name of School District in which resources will be used. If multiple districts, please list all, or if used by an organization other than a school, please provide the name and description here:
(Maximum response 255 chars, approx. 5 rows of text)
*
6.
Question - Required -
City and State:
7.
Question - Not Required -
Please share any other information about your school, district, or organization here:
*
8.
Question - Required -
Which resources would you like to receive (check one or both)?
After-school Activity Guide
Classroom Lessons
*
9.
Question - Required -
Please describe the population to be reached (grade, subject, afterschool club name, etc.)
(Maximum response 255 chars, approx. 5 rows of text)
*
10.
Question - Required -
Approximately how many students will you plan to reach using these resources?
Spam Control Text:
Please leave this field empty