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First Name *
Last Name *
Email Address *
Phone Number *
Have you had a chance to check out the calendar on our website? Please do so before answering the next question. *
Which day would you like us to present? Format: mm/dd/yyyy. Any weekday on our calendar that does not have a school listed and does not indicate that there are no presentations available is a day that we will be available to present. *
School or Organization's Name: *
Age Range: *
Please provide us with a copy of your bell schedule (or a link to your bell schedule).  Or please let us know time(s) for all presentations that day. *
Where will the presentation take place? *
Please provide the first and last names of any instructors/leaders who will be attending the presentation(s).
How many class periods will be presented to during the day? *
How many kids will be at one individual presentation? *
What is the total number of kids that will attend a Block the Blaze presentation? *
Will the following items be available on the day of the presentation? *
How did you hear about us? *
Does your group change each semester? *
Would you like to set up an additional presentation for next session? *
Thank you for filling out this form! We will be in touch to finalize your presentation date.
Please email with the subject "Presentation Scheduled" (no message required)
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