Educator Application Form

Educator Application Form

Please fill out the form to apply for a chance to receive Lysol® Minilabs Kit for your classroom, school, or district.
Your contact information:*

First NameLast Name
Phone Number:*
Please enter a valid phone number.
Your work email address:*
Please make sure to enter the email address associated with your school. Otherwise, you may be disqualified.
What is your role?*

Classroom TeacherScience TeacherHealth TeacherSchool NurseSchool LibrarianSchool AdminDistrict AdminOther
Please share the name of your school's district:*
How many elementary schools are in your district?*
How many Public Title 1 elementary schools are in your district?*
Search for Your District’s Address (type your address in the "Address" field below)*
Have any schools in your district used Lysol® Here for Healthy Schools resources in the past?*

YesNoI'm not sure
What grade(s) will you be teaching for the 2025-2026 school year? (Please note that Lysol® Minilabs Kit is only available for 1st and 2nd grade classrooms)*

Kindergarten1st2nd3rd4th5thOther
How many 1st and 2nd grade classrooms do you teach?*
How many 1st and 2nd grade students will you teach in the next academic year?*
Is your school a Public or Charter Title 1 School?*

YesNo
How many 1st and 2nd grade classrooms does your school have?*
How many students are in each of the 1st and 2nd grade classrooms?*
Your School Name:*
Search for Your School’s Address (type your address in the "Address" field below)*
Is your school mailing address the same as your school address?*

YesNo
Your School's Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Have you used Lysol® Here for Healthy Schools resources in the past?*

YesNoI'm not sure
I am opting into receiving information and newsletter from Reckitt Marketing team.*

YesNo
By submitting this form, you accept that your information may be shared with third party partners including but not limited to Lysol®, and you have read and agreed to The GIANT Room's privacy policy.
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