Out-of-School Innovation Kit Reservations
Your Name *
Your answer
Organization *
Your answer
Program Name *
Your answer
Email *
Your answer
Phone number *
Your answer
Kits Requested
*
Required
Approximately how many youth will use the kit? *
Your answer
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.
Your answer
Delivery/Pick-up *
Do you need coaching about how to use the kit? If so, please provide describe your needs. *
Your answer
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