Booking Form

MY INFORMATION

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School / Organization Information

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Please see our Price Sheet Thank you!
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Dates:
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COORDINATOR INFORMATION


The Coordinator is the person who works closest with UP and OVER in coordinating all the details of the day(s). The coordinator must be part of the Host School staff, and must be a school administrator, a teacher or a counselor working closely with the administration.

We suggest that a counselor or licensed mental health professional, employed by the school, be available to ensure follow-up services to students if needed.
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School Principal

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ADDITIONAL SCHOOL/ORGANIZATION INFORMATION

Please fill out this section as thoroughly as possible. Your information helps us create the best program possible for your school or your organization.
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ISSUES AND GOALS


This is where you describe to us the issues you see and the goals you hope for. (If you are filling this out for an organization, please read "organization" instead of "school" in the following questions.) Please be as complete as possible. Thanks! Please describe the social climate at the school. How do people interact with each other? How do you see your school? Have there been any recent tragic or traumatic events? What are the challenges at the school? What are the opportunities?
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