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Water-Wise Workshops Request Form

Request Form for Water-Wise Workshops
School Address
School Address
Street Number and Name
Additional Information
City
State/Province
Zip/Postal
School, teacher or administrator only.
In case of questions on the day of the presentation.
Personal or work, whichever is best to reach you.
Different teacher or administrator - in case of difficulty reaching the primary contact.
We are able to provide one lesson to multiple classes in one school day.
Please select the Sunday at the beginning of your requested week. Please give at least 1 week advance notice.
If requesting multiple days for multiple teachers, please submit a separate request for each date.
Grade Level
Total Number of Classes
1st Program: Start Time
1st Program: End Time
2nd Program: Start Time
2nd Program: End Time
3rd Program: Start Time
3rd Program: End Time
4th Program: Start Time
4th Program: End Time
5th Program: Start Time
5th Program: End Time
6th Program: Start Time
6th Program: End Time
Laptop/Projector: Do you have a laptop and projector available for our use? These are not needed but if available, we can add visuals.