Yes, PLEASE! is Mazzoni Center's free, comprehensive, affirming health and wellness education program. The information you include on this form will help our team to assess your needs and start off on the right track. We encourage you to submit requests for the current school year as soon as possible so that we can start the this year off strong!

Please complete this form in as much detail as possible. Reach out to youthprograms@mazzonicenter.org with any further questions.

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* 1. Your Contact Information

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* 2. Desired Grade Level(s)

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* 3. Please indicate sessions you are interested in. We recommend a minimum of 2 sessions for each group of students.
NOTE: ^ Denotes lessons available for 3rd-6th grade.

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* 4. Desired Month to Begin Programming:

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* 5. Desired Programming Days: (Select all that apply)

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* 6. Desired Programming Time: (Select all that apply)

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* 7. Please rank how LGBTQ+ affirming your school or program is:

0 (not affirming) 100 (very affirming)
Clear
i We adjusted the number you entered based on the slider’s scale.

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* 8. Would you like to receive safer sex kits which include condoms, lube, and instructions on how to use them?

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