2017 Floating Classrooms Application
School Information
School Name:
Your answer
Street Address, City, State, Zip Code:
Your answer
School Phone Number:
Your answer
School Principal:
Your answer
Primary Contact Person
Name:
Your answer
Title:
Your answer
Best Contact Phone Number:
Your answer
Email:
Your answer
Person Signing Agreement
Name:
Your answer
Person Writing Letter of Recommendation
Name:
Your answer
Group Demographics
Participant age:
Required
How many students will be attending? If you are not completely sure, put the highest number of students expected?
Your answer
Number of female participants:
Your answer
Number of male participants:
Your answer
How many students are on free or reduced lunch?
Your answer
How many of the attending students are English language learners?
Your answer
How many of the attending students are in Vermont through the Vermont Refugee Resettlement Program?
Your answer
How many participants live in a single-parent household?
Your answer
Additional Group Information
What are your students' concerns about sailing?
Your answer
Are there accommodations your students will need to be successful?
Your answer
What goals do you have for your group?
Your answer
Any suggestions for the CSC instructors?
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of Lake Champlain Community Sailing Center. Report Abuse - Terms of Service - Additional Terms