please complete the form below to confirm your interest. i look forward to working with you! Name * First Name Last Name Email * Phone (###) ### #### Name of organization: * What is your role/ position at this organization? * Where is your organization located? * What would you like me to do for your organization? * What will be the age of the the participants? * Please check all that apply. Young children (up to 5 years old) Elementary school (6-10 years old) Middle school/ pre-teens (10-13 years old) High school/ teens (13-18 years old) Adults Older adults (70+ years old) Is there anything else you'd like me to know about you or your organization? Thank you!
