CATCH My Breath Presentation Request Form
CATCH My Breath is an evidence-based vaping prevention program that provides students with skills to resist peer pressure and media influences to try e-cigarettes. Through this program, students develop strategies to resist their own curiosity as well as peer and advertising pressure to experiment with e-cigarettes. They also leave the class understanding the dangers of e-cigarette use. This program can be administered to students grades 5-12. CATCH My Breath consists of four lessons that are about 35 minutes each.


Please complete this form to request CATCH My Breath presentations for your students.
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First and Last Name *
Email *
Phone Number *
School *
How many classes would be receiving the program?
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What grade(s) would be receiving the program? (Select all that apply) *
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What month(s) would you like to host the program? *
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What day(s) of the week work best for you? *
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What time of day would the program be offered? Please give as much detail as possible. *
Do you have any questions or comments about the CATCH program or scheduling?
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