Education Program Request

District Education Form

Name 

*School/Organization 

*Only groups within Hamilton County are eligible for District education programs.

Address 

Email 

Phone 

Program Classroom  Field Trip  Assembly   Adult Lunch & Learn

Which specific program interests you? 

# of participants 

Grade Level 

1st Preferred Date 

2nd Preferred Date 

Preferred Time 

Is your school registered with our LSW (Let's Stop Waste at School program)?  Yes   No   Don't know

Additional Notes or Questions



Security Measure