Request edit access
Kit Request Form
APM can only provide free kits to 4th, 5th or 6th grade classrooms in underserved schools (defined as at least 30% of the school population eligible for free and reduced lunch)
Sign in to Google to save your progress. Learn more
Email *
What is your name?
 *
What is the name of your school?
 *
What is your role at the school?
 *
What grade are the students who will use the kits?
 *
Which kit would you like?
 *
How many students will use the kits?
The kits are completely free, and designed to be taught with one kit per student.
 *
When do you want the kits to arrive?
We ask that you please use the kits within one month of receiving them.
MM
/
DD
/
YYYY
What address should we send the kits to?
 *
When can we meet?
We want to support you in using these kits. Can we schedule a call to discuss the student and teacher resources included with the kits. Please share a few dates and times when we can reach you.
*
Is there anything else we should know?
For example, do you have any questions or would you like to schedule a field trip to the museum?
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms