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4. 
5. Student programs are conducted March - May, Monday through Friday from 8:30 a.m. to 4 p.m., depending on the program selected. Please check for open dates on the Education Calendar.
   
   Please let us know at the time of scheduling if there is a vacant classroom. We would prefer to be stationary and have students come to us.
   
   Please note, this is a request form and not a guarantee of a scheduled program.
7. Have you had a SWA program in the past?

   1. Yes
   2. No
9. Contact Name*
11. School / Organization Name*
13. Address1*
15. Address2
17. City*
18. State*
19. Zip*
21. Contact Phone Number*
22. Email Address*
24. How did you hear about us?*
26. Environmental Lesson Details
28. Environmental Lesson Selected*
    -- Select One --K - Less is More!1st - How Do We Recycle?2nd - What Are The 4 Rs To Being Green?3rd-5th - How Is Paper Recycled Into New Paper?6th-12th - How Are Plastics Separated?

    Please fill out a new form for each grade level.
30. Date / Time - 1st Choice*
    Date / Time - 1st Choice

    Date / Time - 1st Choice
31. Date / Time - 2nd Choice*
    Date / Time - 2nd Choice

    Date / Time - 2nd Choice
32. Date / Time - 3rd Choice*
    Date / Time - 3rd Choice

    Date / Time - 3rd Choice
34. Grade*
35. # of Participants*
    Please note we can only see 40 students max per program.
36. # of classes*
38. Additional Notes
    Let us know if you have any special requests or need any special accommadations
40. Please note, this is only a request. An education staff member will be in touch with you within 72 hours.
Leave This Blank:


42. 1. Receive an email copy of this form.
43. Email address

    This field is not part of the form submission.

44. Submit Submit and Print

* indicates a required field