Kit Check-Out Form

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Kit Check-Out Form

Thank you for your interest in the PPRV/Pollinator Pals education kits! Please provide the following information so we can get you your kit.

Email *

Your name *

Your phone number *

Name of school/organization and School District (if applicable)
*

Which kit are you checking out? *

Adopt-a-Seed

Intro to Pollinators: Flowers

Pollinator Count

Other:

What is the class size? (this is to ensure we have the appropriate amount of materials to serve each student) *

When do you need the kit by? (date and time) *

Please pick up the kit from our office at 312 N. Main Street, Suite B, Phoenix, OR. Please advise if you need it delivered. *

Yes, I can pick it up

If you need the kit delivered, what is the address it needs to be dropped off at?

Date kit will be returned/picked up. Please return it within 2 weeks of pickup so that we can have it available for other instructors. *

Thank you for utilizing our Pollinator Pals resources!

Please contact us if you have any questions or suggestions.

Ethan.pprv@pollinatorprojectroguevalley@gmail.com

775-376-3461

Please feel free to share our resources with other instructors.

https://www.pollinatorprojectroguevalley.org/pollinator-pals

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