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Order activ8
To order activ8:
Teacher
Principal
School Administrator
Other:
Mr.
Mrs.
Miss
Ms.
First Name:
Last Name:
School Board:
School:
School Address:
City/Town:
Province:
Postal Code:
Tel:
Fax:
E-mail:
Preferred communications: Telephone
Fax
E-mail
Preferred Languages:
English
French
Please Note:
Early Year Providers, you are only required to fill in information below that is applicable to your work. If you are unable to answer particular questions below, you may leave it blank.
Total number of students in school:
Number of students per grade who will be participating in the program:
JK
K
1
2
3
4
5
6
7
8
Number of teachers using activ8:
JK-K
1-3
4-6
7-8
*Please note activ8 is available in four modules (JK-K, 1-3, 4-6, 7-8). Supplies are limited and will be fulfilled based on student/teacher ratio.
Where did you hear about the activ8 program?
Colleague(s)
Flyer/letter sent to my school
At a conference (please specify)
I’ve used activ8 before
Active Healthy Kids Canada website
Ophea website
Other (please specify)
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