Classroom Information and Resource Request
Fill out this form to let us know which resources you are interested in so we can provide you with all necessary materials!
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Teacher Name *
Email (School Email Preferred) *
School Phone Number with Area Code and Extension (if applicable) *
School Name *
City and State of School *
School District *
Which resource are you interested in? NOTE: You may select more than one, however; multiple resources will only be checked out on a case by case basis and/or based on availability. *
Required
How many students will be utilizing your selected resource(s)? *
Since we are grant funded, we need to collect data to inform our amazing funders. Do you agree to complete the demographic data form provided by High Sierra AHEC for all students participating in the programs (student identifying information will NOT be collected)? If you agree, type your full name below. *
Do you have any other questions, concerns, or comments?
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