Request an Activity

Fill out the below form to request an activity from ALCOSAN's Scholastic Outreach Department.

School/Organization*

School District

First Name*

Last Name*

Title*

Address of Presentation

Street*

City*

State*

Zip Code*

Phone*

Email*

Are you a first time requestor?*

Dates

Share your top three preferred dates and we’ll do our best to accommodate. Please also allow us 10 business days to process your request.

First Preference

Second Preference

Third Preference

Time

Lessons run approximately 30-35 minutes for Pre-K and 40-45 minutes for K and up. If scheduling multiple classes, please allow five minutes between lessons for prep. Please list the times for each class you would like us to visit for the day.

Class Time(s)*

Grade Level*

(We serve students age 3+)

Room number*

(Rep must remain in the same room if instructing multiple classes)

Number of Adult Support*

(Preferred ratio is 1:10)

Total Number of Classes*

Total Number of Students*

Number of Students Per Class*

Activity

Please choose an activity that corresponds to the developmental grade level of your students. If you do not have a preference, our rep will select an activity for you.

Select an activity

Additional Requests

New code

Please type the code above

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