*1.School District(Required.)

*2.School / Site Name(Required.)

3.Team Coordinator

Name

Email Address

Phone Number

4.Team Coordinator Preferred Method of Communication

Work Phone

Cell Phone

Email

5.Best Time(s) to Connect

Times

Planning Period

7am-8am8am-10am11am-1pm1pm-3pm3pm-5pm5pm-7pm

Morning

7am-8am8am-10am11am-1pm1pm-3pm3pm-5pm5pm-7pm

Lunch

7am-8am8am-10am11am-1pm1pm-3pm3pm-5pm5pm-7pm

Evening

7am-8am8am-10am11am-1pm1pm-3pm3pm-5pm5pm-7pm

6.Semester

FALLSPRING

*7.Please select the name of the program you will be providing to parents this sementer.
Note: If you are planning to offer multiple programs this semester, please fill out a survey for each program.(Required.)

Calm & Kind Family

Family Meals Challenge

Parenting Partners

*8.Enter the date you plan to START your workshops. 
Note: If you are still unsure of the exact date, please indicate the week or month you hope to start.(Required.)

*9.How many parents are you planning to invite?
Pro Tip: Invite twice as many people as you'd like to have in your workshops. For example, invite 40 if you'd like to have 20 parents attend.)(Required.)

10.Please indicate the names of the facilitators who will be helping lead your workshops this Fall.

Facilitator 1

Facilitator 2

Facilitator 3

Facilitator 4

Facilitator 5

Facilitator 6

11.Additional Notes/Comments for your Team Support Specialist