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* Name:

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* Email:

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* Phone number:

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* School (please select from the drop-down menu):

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* Which grade(s) do you teach? (select as many that apply):

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* What time of day works best to offer this presentation?

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* Is there a specific date you require?

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* How would you like us to offer the presentation?

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* Do your students require special adaptations for presentations (e.g. EAL class)? What are we able to do to adapt our presentations to meet your needs?

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* How did you hear about this presentation?

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* Additional comments:

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