PowerUp School Challenge Application

School Contacts

Question Title

* 1. School

School Name

District

Question Title

* 2. School Address

Street Address

City

County

State

Zip

Question Title

* 3. Principal

Name

Email

Question Title

* 4. Phy. Ed. Teacher

Name

Email

Question Title

* 5. Food Service Contact

Name

Email

Question Title

* 6. School Nurse

Name

Email

Question Title

* 7. PTO/PTA Contact

Name

Email

Question Title

* 8. School Challenge Site Coordinator
(This person will be the main contact person between PowerUp and your school. Find the Site Coordinator Position Description here.)

Name

Email

Phone

Position at School