Out-of-School Innovation Kit Reservations
Your Name *
Organization *
Program Name *
Email *
Phone number *
Kits Requested
*
Required
Approximately how many youth will use the kit? *
Date needed *
MM
/
DD
/
YYYY
When will you be done with the kit(s)? *
MM
/
DD
/
YYYY
Are these dates flexible? If so, please describe.
Delivery/Pick-up *
Do you need coaching about how to use the kit? If so, please provide describe your needs. *
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