Request for Summer Outreach Program

REQUEST FOR SUMMER OUTREACH PROGRAM

Thank you for your interest in a Schiele To Go program!

Please note – submitting this form does not guarantee an outreach program. Our scheduling staff will respond to your request, book your appointment, then send written confirmation of that appointment.

Organization Information

Proposed Date(s) of Visit

Program Preferences When selecting multiple programs, please indicate in the comments section if you would like multiple programs on the same day or if you are looking to schedule multiple outreach programs on different days.