Request for Canada C3 Giant Floor Map
Email address *
School Information
What is your name? *
Your answer
What is the name of your school? *
Your answer
What grade level do you teach? *
Your answer
How many students are in your class? *
Your answer
How many students are in your school? *
Your answer
Approximately how many students will be using the map while at your school? *
Your answer
What is your school mailing address? Street number and name, city, province and postal code. *
Your answer
What is your school phone number? *
Your answer
Selecting your preferred dates
Below, please list three 3-week periods when you would like to have the Canada C3 giant floor map. Please display which period is your first, second and third choice. We will do our best to accommodate your first choice.

EXAMPLE:
First Choice: Starting September 4th, 2017
Second Choice: Starting September 25th, 2017
Third Choice: Starting October 9th, 2017
*
Your answer
A copy of your responses will be emailed to the address you provided.
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