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Out-of-School Innovation Kit Reservations
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Your Name
*
Your answer
Organization
*
Your answer
Program Name
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Your answer
Email
*
Your answer
Phone number
*
Your answer
Kits Requested
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Nature Art
Survival Skills
Habitat Investigations
Required
Approximately how many youth will use the kit?
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Your answer
Date needed
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MM
/
DD
/
YYYY
When will you be done with the kit(s)?
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MM
/
DD
/
YYYY
Are these dates flexible? If so, please describe.
Your answer
Delivery/Pick-up
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I am able to pick-up the kits (Monday-Friday, 8:30am-4:00pm in Bend)
I need the kits delivered to my program
Do you need coaching about how to use the kit? If so, please provide describe your needs.
*
Your answer
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