Kids Against Bullying PACER Puppet Show Request

Thank you for your interest in scheduling a Kids Against Bullying puppet show at your elementary school! You must enter all contact information (Question 1) in order to submit this form. If you are unsure about how to complete any other questions on the form, you can leave them blank and we will discuss with you when we follow-up on your request. If you have any questions, call PACER at 952.838.9000 or email puppets@pacer.org. Thank you!

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* 1. Please provide your contact information:

Contact Name & Title:

School District:

School Name:

Address:

City:

ZIP:

Main Office Phone:

Contact Email Address:

Contact Phone Number:

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* 2. Please provide billing name and address. Cost is $100 per show.

Name & Title:

Address

City:

ZIP:

Phone Number:

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* 3. How many Kids Against Bullying shows are you requesting? (Maximum of 3 shows can be presented in 1 day.)

# of shows

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* 4. For each show, list grade level and number of students and adults per show. (Maximum of 60 students or 2 classrooms per show.)

Show 1 Grade Level

Show 1 # of Students

Show 1 # of Adults

Show 2 Grade Level

Show 2 # of Students

Show 2 # of Adults

Show 3 Grade Level

Show 3 # of Students

Show 3 # of Adults

Show 4 Grade Level

Show 4 # of Students

Show 4 # of Adults

Show 5 Grade Level

Show 5 # of Students

Show 5 # of Adults

Show 6 Grade Level

Show 6 # of Students

Show 6 # of Adults

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* 5. Please provide some information about the site and room where the show(s) will be held. (Room should be quiet, large enough to seat students on the floor in front of our puppet stage, and available 30 minutes ahead of first show for set-up.)

Room name for show

Location for parking

Door to enter

Best place to unload equipment

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* 6. Please list your preferences for date and time of show(s).

Preferred month

Preferred days of week

Preferred time of day

Any dates during selected month that are not available?

Time School begins

Lunchtime(s)

Time School ends

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* 7. Any additional information or special requests?

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* 8. Informational letters in English are provided for the
students to take home following the presentation. If you would like the letter in Spanish, please enter the quantity.

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* 1. Please provide your contact information:

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* 2. Please provide billing name and address. Cost is $100 per show.

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* 3. How many Kids Against Bullying shows are you requesting? (Maximum of 3 shows can be presented in 1 day.)

Question Title

* 4. For each show, list grade level and number of students and adults per show. (Maximum of 60 students or 2 classrooms per show.)

Question Title

* 5. Please provide some information about the site and room where the show(s) will be held. (Room should be quiet, large enough to seat students on the floor in front of our puppet stage, and available 30 minutes ahead of first show for set-up.)

Question Title

* 6. Please list your preferences for date and time of show(s).

Question Title

* 7. Any additional information or special requests?

Question Title

* 8. Informational letters in English are provided for thestudents to take home following the presentation. If you would like the letter in Spanish, please enter the quantity.

* 8. Informational letters in English are provided for the
students to take home following the presentation. If you would like the letter in Spanish, please enter the quantity.