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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
Please complete the following information about your school:
(Required.)
School Name
School District
County
School Population
School Address:
(Required.)
Street
City
Zip Code
Has your school ever participated in any of the following: Joint Use/Shared Use Agreements, CWIP, SPARK, FUTP60 or C-DASH/CSH?
(Required.)
Yes
No
Do you have an active school wellness committee that meets at least twice yearly?
(Required.)
Yes
No
Have you ever participated in the Great Arkansas Workout? (Prior participation is not included in the selection process.)
(Required.)
Yes
No
Contact Information:
(Required.)
Contact Person's Name
Contact Title
Telephone # (include area code)
FAX #
E-Mail Address
