Please take 2 minutes to complete this brief survey so we may better support your needs.

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* 1. How can we reach you or an authorized representative of your organization?

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* 2. What skills do your participants need to develop?

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* 3. Which age groups do you serve?

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* 4. HOW MANY PARTICIPANTS WOULD YOU LIKE US TO TEACH?

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* 5. When is your ideal start date?

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* 6. How did you hear about us?

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* 7. What space and/or equipment is available?

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* 8. Which of the following will most help you create impact for your school or organization?

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* 9. Which of the following social determinants of health are affecting your community as a whole? (According to the CDC, "They are the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life. These forces and systems include economic policies and systems, development agendas, social norms, social policies, racism, climate change, and political systems.")

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