SMHRT Curriculum Request Form
A copy of this curriculum will be sent to the address provided upon completion of this form. Thank you!
Email address *
Full Name: *
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Mailing Address: *
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Phone Number: *
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Do you plan to use this curriculum for personal or professional use? If it's for professional use, please share the name of your organization.
Your answer
Were you a part of the SMHRT Community Advisory Team? *
How many copies of the curriculum would you like us to send you? (Max of 2 copies) *
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Where do you plan to use this curriculum? (City, State, School Name, etc.) *
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How many teachers would potentially use this curriculum? *
Your answer
Which grade levels would utilize this curriculum? *
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How many students would potentially use this curriculum? *
Your answer
Would you be okay with our team contacting you in the future to provide us with feedback on the curriculum?
Would you like to receive our monthly SOAAR newsletter? *
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