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* 1. What is your name and the name of the organization you are affiliated with?

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* 2. Please provide the web address and contact information for your organization.

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* 3. Does your organization provide materials or handouts on Health and Wellness topics to educators to use in their classrooms?

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* 4. Does your organization provide guest speakers on Health & Wellness topics? (If there is a cost associated with the speaker, please note.)

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* 5. Does your organization provide on-site activities for students? (Also note if these are one-time events, multiple session events, or if there is a cost associated.)

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* 6. Does your organization provide workshops, activities or classes for teachers or educators? (Also note if these are one-time events, multiple session events, or if there is a cost associated.)

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* 7. Does your organization provide education, events or activities for parents and children together? (Please note if these are one-time events, multiple session events, or if there is cost associated.)

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* 8. Does your organization provide health fairs, assemblies or other school-wide events? (Also note if there is cost associated.)

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* 9. Please list sources such as grants, charitable organizations, etc., who provide funding for classroom equipment and supplies.

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