SCHOOL REGISTRATION FORM

Please fill out the School Registration form below:
Today's Date*

MonthDayYear
School Name*
Principal's Name*

First NameLast Name
Principal's Email*
Principle's Phone Number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Website
Contact Information
Full Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Email*
Secondary Contact Information
Secondary contact's name

First NameLast Name
Secondary contact's title
Secondary contact's email
Secondary contact's phone

Area CodePhone Number
Class Information
Grade level
Name of class
Subject being taught
Number of students in class
Additional Information
Best form of communciation*

PhoneMobileEmailText
Preferred days?*

MondayTuesdayWednesdayThursdayFriday
Are you an active member of the East End Edible School Garden Group?*

YesNo
Areas of interest*

GardeningCooking Demonstrations: In ClassroomCooking Demonstrations: In CafeteriaIn classroom education about healthy eating or cookingIdeas for menu and recipe development
Other areas of interest or idea
Should be Empty: