APlus Programming Request Form
The information provided in this form will be used to develop a program proposal that best meets your needs. This information is confidential and will not be shared with anyone outside the APlus Team.
Name of School/Program *
Your answer
Name of Contact/Person requesting program *
Your answer
Contact email address *
Your answer
Contact Phone Number *
Your answer
Type of program requested *
Required
Number of participating students *
Your answer
Preferred program delivery *
Required
Preferred Program Date(s) *
Your answer
Budget Guidelines for Proposal *
Add any additional information here that you feel would be helpful for us to know in developing your proposal.
Your answer
If requesting ACT Prep for your school, please provide the following.
What is the average Pre-ACT composite for participating students? *
Your answer
What percentage of participating students met the proficiency score of 17 or more on the 2017 ACT? *
Your answer
What is your proficiency percentage goal? *
Your answer
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