KCWH TCWH - School Interest Form

Kids or Teens Cook With Heart School Interest Form

If you are a principal or teacher interested in bringing Kids Cook With Heart or Teens Cook With Heart to your school, please complete the following interest form.

Step 1: School Information
School Name:*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
School website:*
Your Full Name*

First NameLast Name
E-mail*
Your Position at the School:*

PrincipalTeacher
If you are a teacher, please provide the following:
Name of Principal:
Phone Number

Area CodePhone Number
E-mail
Our school participates in the following AHA programs/events:

Jump Rope For HeartHoops For HeartGo Red For WomenBe The Beat / CPROther
Our school would like more information about:
Section 2: Curriculum Integration
1. Grades Please indicate what grades you would like to participate *
Time of day:

During schoolAfter school
2. Please mark all the subject area(s) in which you would incorporate Kids Cook with Heart / Teens Cook With Heart. (Check all that apply.)

MathScienceSocial StudiesHistoryHealth/ NutritionLanguage ArtsMusicPhysical EducationEnvironmental EduationOther
Should be Empty: