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Request for Camp Kesem Resources
Thank you for your interest in Camp Kesem at Christopher Newport University! We would love to send you more information about our programming for personal use or distribution. These resources can be emailed to you digitally or can be printed in hard-copy format and be mailed to your residential or business address. Please note that not all requests can be guaranteed at this time but we will do our very best to accommodate your needs. After you complete this form, you will receive a follow up email from our outreach coordinators (
christophernewportu.outreach@campkesem.org
) regarding your requests.
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* Indicates required question
Email
*
Your email
Please provide your first and last name:
*
Your answer
What is your relationship to Camp Kesem?
*
Community Organization/Partner
Prospective Camper Parent/Guardian
Other:
Follow Up: If you answered "Community Organization/Partner" please specify the organization you are affiliated with and your position
Your answer
Can you speak and understand English? (If not, please specify your preferred language)
*
Yes
Other:
Is your request for personal use or distribution?
*
Personal use
Distribution
Other:
Follow up: If you selected "distribution" please specify who you are going to distribute these resources to [For example: students, patients, clients, friends, etc.]
Your answer
What type(s) of resources would you like to request? [select all that apply]
*
Business Cards (with our contact information and camp dates)
Tri-fold brochure about our chapter's programming
Tri-fold Brochure about Kesem National
2023 Camper Application [hard-copy format]
[1-sided] Flyer about our 2023 Friends & Family Day event (Date TBD)
[1-sided] Flyer with step-by-step instructions about how to apply for Kesem at Home
ADA Compliant Camp Kesem Info Sheet
Camp Kesem Graphic to post on social media platforms
Introductory Paragraph and Graphic about Camp Kesem for monthly newsletters or promotional resources
[Digital Resource Only] Link to our pre-recorded Camp Kesem Info Session
[Digital Resource Only] Link to our Calendly Sign-Up for a live Virtual Info Session with our Outreach Coordinators
[Digital Resource Only] YouTube video link about the Kesem at Home Experience
[Digital Resource Only] Link to Camp Kesem FAQ
Required
How would you like us to send you information about our programming?
*
Digital copy by email [we will use the email provided above unless otherwise stated]
Hard-copy by mail to a BUSINESS address
Hard-copy by mail to a RESIDENTIAL address
Both by email and mail
Other:
Follow up: If you requested digital resources by email, what is your preferred file type [If you would like more than one file type or would like to request a file type that is not already listed below, please specify your request in the "other" section]
JPEG/PNG
PDF
Google Drive Link
Other:
Clear selection
Follow up: If you requested hard-copy resources by mail, what is your preferred mailing address?
Your answer
Follow up: How many hard-copy resources are you requesting? Please specify the number of resources needed for each requested resource type indicated above. [note: not all requests are guaranteed]
Your answer
Do you need any resources provided in a language other than English? [note: not all requests are guaranteed]
*
Yes
No
Other:
Follow up: If you answered "Yes" please specify which language(s)
Your answer
Follow up: Please specify which resource types (indicated above) you need provided in a different language
Your answer
Follow up: If you are requesting hard-copy resources in a different language, please specify the number needed for each requested language and resource type. [note: not all requests are guaranteed]
Your answer
Is there any specific information you would like to make sure is included in your requested resource(s)? Please indicate the resource type and specific request [For example: "I would like to make sure that the date for Friends & Family Day is included on your business card"]
Your answer
Please note any additional questions, concerns, or requests here:
Your answer
How did you hear about us? [please be as specific as possible]
*
Your answer
Send me a copy of my responses.
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