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Cromwell Center classroom programs: school request form

IMPORTANT NOTE FOR 2025-2026 SCHOOL YEAR:
We schedule programs on a first-come first-served basis based on the date you submit this online form and our funding capacity this school year, which is more limited than usual. If your school or district has ANY funding available to help offset the costs for bringing these programs to your school, please check the box below and we will reach out to you.
Please be patient as we work to accommodate everyone's specific requests/timelines. We will email you when we are ready to schedule your school.

If you are requesting programs for multiple schools, please submit a separate request form for each school.

Please encapsulate all your school's grade levels that want programs into one request form rather than submitting separate forms for each grade level, etc.

We welcome donations from schools and community groups that are able to support the delivery of our programs financially.
1.FOR CROMWELL OFFICE USE ONLY:
Calendar______
Schedule______
Assign______
Confirm______
Eval______
2.Your name(Required.)
3.Your role (school counselor, principal, teacher, etc.)(Required.)
4.School (please don't use abbreviations because this is the name that we use in our reporting)(Required.)
5.Mailing address (street or PO box)(Required.)
6.City or Town(Required.)
7.ZIp code(Required.)
8.Phone number

(Required.)
9.E-mail address

(Required.)
10.Please indicate yes or no:
  • Our school understands and can accommodate the time requirements for each program: 30 minutes for each grade 1 classroom; 45 minutes for each grade 2 classroom; 60 minutes/1 hour for each grade 3 classroom; and 75 minutes for each grade 4, 5, or 6 classroom.
  • Our school will work with The Cromwell Center to create an efficient programming schedule by fitting multiple sessions into each day, avoiding early-release days, and avoiding long gaps between sessions to the extent possible.
(Required.)