Youth Education Programs Request Form 
Miami Waterkeeper is proud to students and the community of Miami-Dade County. Floating Classrooms/YEA Days are typically hosted from 10am-1pm and include time for lunch (Miami Waterkeeper does not provide lunch). If you are a Title 1 school, there is no fee for these programs. All other groups such as non-profits, for-profit companies, private groups/schools, or corporate groups, will have associated fees. Please provide as much information as you can when submitting this form. 
Email *
Which program do you want to participate in? *
First Name *
Last Name  *
School/Organization Name *
Title/Affiliation *
Contact Email  *
Contact Phone  *
Address (include street number/name, city, state, zip *
School District (if applicable)
Type of School/Organization
 *
Does your school receive Title 1 funding?
 *
Grade range of target students
 *
Are your students participating through a club or group?
 *
If yes, what is the name of your group?
 *
Number of students participating in activity?
 *
Number of chaperones participating in activity?
 *
Do your students or chaperones require any special accommodations?
 *
Please select your preferred dates  *
Required
Do you have funding to cover the associated costs for the event (pricing can be found in the Youth Education Programs Brochure)  *
How did you hear about Miami Waterkeeper? *
Do you have any additional notes or questions for our education team?
Submit
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