2016 Central Arkansas Great Arkansas Workout

School Application Form

This is an application to participate in the Central Arkansas Great Arkansas Workout on April 26, at the UCA campus in Conway. Applicants will be notified whether or not their school is accepted to attend the event

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Please complete the following information about your school:

School Name

School District

County

School Population

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School Address:

Street

City

Zip Code

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Has your school ever participated in any of the following: Joint Use/Shared Use Agreements, CWIP, SPARK, FUTP60 or C-DASH/CSH?

Yes

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Do you have an active school wellness committee that meets at least twice yearly?

Yes

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Have you ever participated in the Great Arkansas Workout? (Prior participation is not included in the selection process.)

Yes

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Contact Information:

Contact Person's Name

Contact Title

Telephone # (include area code)

FAX #

E-Mail Address