The Aim High, Miss High Experience for High School Seniors

Speaker Engagement Request

Ecanoa and the Aim High, Miss High Team thank you much for the opportunity to share the AHMH Experience with your seniors. Please complete the form in its entirety. Upon receipt of all pertinent information, a representative from the AHMH team will contact you within 2-3 business days.

School's Name

Primary Contact Name

FirstLast

Primary Contact Number

Area CodePhone Number

Primary Contact Email

example@example.com

School Website

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Where will the event be held?

How many seniors will be attending the AHMH Experience?

Approximate number of AHMH Books for seniors?

Approximate number of AHMH Books for senior counselors/teachers?

Approximate number of AHMH T-Shirts for seniors?

Approximate number of AHMH T-Shirts for senior counselors/teachers?

Approximate number of AHMH Books and T-Shirts for Principal and Assistant Principal(s)?

Indicate the number of school visits you prefer.

Select the amount of speaking time allotted for the speaker.

Choose your preferred date and time for the 1st AHMH Exp. during the 2025-2026 school year.

If choosing (2) site visits, choose the date and time for the 2nd AHMH Exp.

After the completion of the AHMH Experience, you will receive a link to give feedback. In an effort to support the AHMH Experience with seniors districtwide, will you share our AHMH Exp. Proposal that will be attached to the feedback link with administrators from other schools within the district?

Does the AHMH Team have your permission to use event pictures for promotional purposes?

The Aim High, Miss High Experince