Request edit access
Classroom Program Application
Bring the Hudson River to your school!

Clearwater offers hands-on, interactive programs that will connect your students' lives to our amazing estuary, and chart a course for them to become active members of our community,

Email address *
Group Name *
Your answer
Contact Person *
Your answer
Email *
Your answer
Telephone (mobile)
Your answer
Telephone (work) *
Your answer
Address *
Your answer
Has Clearwater worked with your organization before?
How long ago?
If this is your first Clearwater program, how did you hear about our organization?
Your answer
How will your program be funded?
Are you a Title 1 school?
What is the grade level of your participants? *
Your answer
How many participants?
Your answer
Which classroom program are you interested in?
What are the names of the participating teachers (if you are the contact for more than one class)?
Your answer
Possible program dates?
Your answer
Impossible program dates?
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of Hudson River Sloop Clearwater, Inc.. Report Abuse - Terms of Service