COPE Program Interest Survey

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COPE Program Interest Survey COPE Program Flyer

Email *

What school are you representing? *

What type of group delivery would you be interested in?

Targeted (small number of students)

Classroom (all students)

Entire Grade Level

Clear selection

What grade level would you want to offer groups to?

Kindergarten

First

Second

Third

Fourth

Fifth

Sixth

Seventh

Eighth

Ninth

Tenth

Eleventh

Twelfth

Clear selection

What would be the best time to hold the groups

Monday

Tuesday

Wednesday

Thursday

Friday

Will you be able to commit to delivery of all 7 sessions?

Yes

Clear selection

Please include your contact information for follow up (Name, email, phone number)

Submit

Clear form

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