School Services Intake Form
Thank you for your interest in SEEDS! Please submit this form to schedule a meeting with a staff member to collaboratively create a program that meets your needs.
Email address *
School/Organization Name *
Contact Name *
Contact Phone Number *
Contact Email *
Best time to reach you *
9AM - 1PM PST
1PM - 5PM PST
Monday
Tuesdays
Wednesdays
Thursdays
Fridays
Number of students served by school/organization *
Grade levels served by school/organization
Percentage of school on free/reduced lunch
Number of staff members at school/organization
Why are you reaching out? What issues are you hoping to address? *
Please describe the adult/student and adult/adult relationships at your school/organization
How did you hear about SEEDS?
Submit
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