Classroom Presentation Request
Use this form for IN-PERSON classroom presentations only.

Be aware that in-person presentations require that presenters be able to present unmasked and not provide medical information. For our full guideline in this regard, see the following link: bit.ly/rlrcv19guidelines.

If the above requirements cannot be met, please fill out a request for our Digital Youth Program: bit.ly/digitalprogramregistration.

Virtual Trainings for staff can be requested through this form: bit.ly/virtualtrainingregistration.
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Brief Program Overview

Page 13 and 14 of our Program Overview fully explains each topic we cover and the length of each package: bit.ly/completeschooloverview.  

BASIC PACKAGE: Topics 1, 2 & 5
- Approximately two 50 minute lessons.

MOST POPULAR: Topics 1, 2, 4 & 5
- Approximately three 50 minute lessons.

FULL PROGRAM: Topics 1, 2, 4, & 5
- Approximately five 50 minute lessons.
Which classroom program are you interested in? *
Availability and bell schedules (standard, block, alternating, etc.) might impact which package you end up receiving. Pick your most ideal.
Required
Personal Information
Name (first & last) *
Title/Position *
Grade (if student or teacher)
Email *
Phone Number (please put the number that is easiest to contact you) *
School Info
Name *
Address (Street, City, State, Zip Code) *
Website *
Bell Schedule *
The exact start and end time of each class period for your grade level and/or school. Ex: 1st Period (7:35-8:32am), etc.
Presentation Details
Note that presenters will arrive 30-40 minutes prior to the start of the 1st class for set up.
The class subject receiving the presentations: *
(Ex: health, history, language arts, media, criminal justice, etc.)
Are there additional teachers in your department that will be receiving the program  as well? *
If yes, please provide their first and last names.
Requested date(s) for presentation(s): *
(mm/dd/yy)  
Class periods that will receive the presentations: *
Specific time (ex: 1st-7th period with 3rd hour prep & 5th hour lunch). Do this for each teacher receiving the program.
Is the presentation location the same as the address given above? *
If not, please provide the address (street, city, state, zip code) of the presentation location.
Additional location details: *
Building number/name, room number, parking instructions, sign-in instructions, etc.
Are there any known alternative schedules during presentation days? *
This can include: study hall days, assembly schedule, half days, fire alarms, lock down drills, etc.
If yes, please provide the dates and alternative schedule(s):
Approximately how many students will be in each class period? *
Will an overhead projector & screen be available? *
RLR will provide our own computer and speaker set up.
Are you teaching a hybrid class (in-person and virtual) and would like a digital option for your virtual students as well? *
Opt-out permission slips are available upon request. Would you like that to be provided by RLR? *
As of making this request, my school's COVID policies allow for RLR presenters to present unmasked, not provide medical information, and social distancing close enough where students will be able to participate in RLR's interactive presentation. *
If no, please fill out a request for our Digital Program instead: bit.ly/digitalprogramregistration
Additional comments: *
If your request is for an in-person presentation, please include as many details as possible about social distancing and other health policies your venue/agency is implementing. RLR's guidelines will also help determine whether an in-person or virtual program will be more effective: https://bit.ly/rlrcvguidelines.
Thank you for requesting a classroom presentation! A copy of your responses will be emailed to the email address you provided. Here are some next steps you can expect after submitting this request:

-- After you submit this form, you will see a link to schedule a virtual meeting with a RLR rep to to confirm the details and logistics of your request, and answer any questions you might have. Schedule during a time that works best for you.
-- Once all logistics are confirmed and dates are set, we will send you a confirmation email that includes all the details of your program, as well as preparation details, expectations, and requested opt-out forms.

We are excited to fight for freedom with you. Welcome to the Rebellion!
(For additional needs, contact programs@redlightrebellion.org)
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