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1. Group, organization, or school name (Required.)

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2. Grade Level (check all that apply)

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3. Contact Person (Required.)

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4. Mailing Address (Required.)

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5. Telephone # (Required.)

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6. Email

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7. Event Location

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8. Event Date
(If you have not chosen a date yet, you can leave this empty and update us by email)

Date

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9. Event Time
(If you have not decided a time, you can leave this empty and update us by email)

Time

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10. Is your event open to the public?

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11. Anticipated number of participants (Required.)

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12. Please share any other information you would like us to know about your event.

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13. The Rick Hansen Foundation School Program offers no-charge educational resources for youth in kindergarten to grade twelve, developed by educators for educators.

Would you like to be registered to receive Rick Hansen Foundation School Program information?

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 100% of survey complete.

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