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2. Forms may not function properly if using Microsoft Internet Explorer 9 (IE9) or earlier. If you experience issues, please call 866-NEW-BINS (866-639-2467).
   
   
4. 
5. Virtual lessons are conducted Monday through Friday, from 8:30 a.m. to 4 p.m., depending on the program selected. Please check the Education Calendar for availability .
   
   All programs are free of charge and available in Spanish.
   
   Please note, this is a request form and not a guarantee of a scheduled program.
   
   
7. Have you had an 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. Virtual Lesson Details
28. Virtual Program Selected*
    -- Select One --SWA for Beginners (K-2nd)Industry & Nature Coexist (3rd & 7th)Recycle Right! (4th & 6th)Renewable Energy (5th & 8th)Full SWA Overview (HS and College)RMPF Technical Tour (HS and College)REF 2 Technical Tour (HS and College)Community SWA Overview

    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*

    Input N/A if college or community group

35. # of Participants*
36. # of classes*
    Input N/A if college or community group
38. Virtual Platform*

    The Education team will create a link for your class to join Microsoft Teams. If you need to use another platform, please indicate below.

    1. Microsoft Teams
    2. Other (please list in notes)
40. Additional Notes
    Let us know if you have any special requests or need any special accommadations
42. Please note, this is only a request. An education staff member will be in touch with you within 72 hours.
Leave This Blank:


44. 1. Receive an email copy of this form.
45. Email address

    This field is not part of the form submission.

46. Submit Submit and Print

* indicates a required field