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Interested in Sand Dollar Club
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Email
*
Name
*
First
Last
Title
What school are you interested in having SDC?
Choose one school site here. You will have an opportunity to provide information about a secondary site later in the form.
Are you interested in hosting SDC at another site?
No
Yes
What type of facilitation are you interested in for the first site?
Bridges Facilitator
I want to facilitate at my school (training provided)
There is another school staff member who will facilitate (training provided).
If you selected “I have another school staff member who will facilitate,” please provide their name and title:
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first site
Group Window of Availability (if known)
Monday Morning (8-11am)
Monday Lunch (11-2pm)
Monday Afternoon (2-4pm)
Tuesday (8-11am)
Tuesday (11-2pm)
Tuesday (2-pm-4pm)
Wednesday (8-11am)
Wednesday (11-2pm)
Wednesday (2-4pm)
Thursday (8-11am)
Thursday(11-2pm)
Thursday(2-4pm)
Friday (8-11am)
Friday(11-2pm)
Friday(2-4pm)
First Site
Estimation of number of students
First Site
Meeting Location Identified
Yes
No
In progress
A comfortable, quiet space where students have a desk or table to complete tasks and chairs to sit in, with minimal distractions and no interruptions.
What is the other school you are interested in having SDC?
What type of facilitation are you interested in for the 2nd site?
Bridges Facilitator
I want to facilitate at my school (training provided)
There is another school staff member who will facilitate (training provided).
If you selected “I have another school staff member who will facilitate,” please provide their name and title: (copy)
*
first site
Estimation of number of students (2nd Site)
2nd Site
Group Window of Availability (if known) (2nd Site)
Monday Morning (8-11am)
Monday Lunch (11-2pm)
Monday Afternoon (2-4pm)
Tuesday (8-11am)
Tuesday (11-2pm)
Tuesday (2-pm-4pm)
Wednesday (8-11am)
Wednesday (11-2pm)
Wednesday (2-4pm)
Thursday (8-11am)
Thursday(11-2pm)
Thursday(2-4pm)
Friday (8-11am)
Friday(11-2pm)
Friday(2-4pm)
2nd Site
Meeting Location Identified (2nd Site)
Yes
No
In progress
A comfortable, quiet space where students have a desk or table to complete tasks and chairs to sit in, with minimal distractions and no interruptions.
Are you interested in the Sand Dollar Club Facilitator Training?
Yes
No
Sand Dollar Club is a 9 week program. Our curriculum requires that students have a full 45 minutes each week to complete activities and meet session goals. I understand that I am responsible for finding a group of students to participate in the club, for reserving a designated space to meet each week, and for securing a day and a 45 minute time frame for each session.
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I understand
Submit