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* 1. Name of School

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* 2. Name of Contact Person

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* 3. Email of Contact Person

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* 4. Grade Level (s) of Presentation

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* 5. Select the presentation(s) that you want to schedule.

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* 6. Please enter two date options (Middle School presentations are 1 day & HS presentations 2 days: Monday-Tuesday or Tuesday-Wednesday)

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* 7. class times for your presentations

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* 8. Number of Students registered for each class (please use your class roster numbers--Thank you!)

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* 9. Are you able to make printed copies of the packets for your students?

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* 10. As a reminder, our speakers are coming to your classroom as a guest speaker and not as a guest teacher. They will not be providing classroom management or discipline and will instead look to you to make sure that the students are being respectful and listening during the presentation.  For the safety of our speakers and your students, we ask that you are present during the entire presentation, meaning that you do not leave the classroom at any time during the presentation (unless to step into the hall to speak to a student-please leave the door open). We also ask that you do not get a substitute teacher to come to your classroom when our speakers are scheduled to come for a presentation. We understand that unforeseen situations happen, so if a substitute is needed, we will reschedule with you and ask that you let us know as soon as possible if this happens. Please type your name below to show that you understand and agree with these protocols. Thank you!

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* 11. Do you have any questions or are there things we need to keep in mind when scheduling?

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* 12. Please provide the email & name for your guidance counselor. We will send copies of any "I Learned" forms that need follow-up to both the classroom teacher and the guidance counselor.

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* 13. I would be interested in hearing more about having a 3-day presentation for my students. This would allow for additional conversations on our topics & some additional resources. If you mark yes to this question, you will be sent and additional information and can determine if you'd like the standard 2-day presentation or the 3rd day option at that time.

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