Survey - School Club Agreement Form

School Club Agreement Form

*1.

Question - Required - Name of School

*2.

Question - Required - First Name of President

*3.

Question - Required - Last Name of President

*4.

Question - Required - Email Address

*5.

Question - Required - Street Address

(Maximum response 255 chars, approx. 5 rows of text)

*6.

Question - Required - City and State

*7.

Question - Required - Zip Code

8.

Question - Not Required - Phone Number

*9.

Question - Required - Name of Club Advisor

*10.

Question - Required - Email address for Club Advisor

*11.

Question - Required - Is there an area of our work that interests you most?

	Education
	Emergency Response
	Newborns & Young Mothers
	Health & Nutrition
	Advocacy
	Gender Equality
	Child Safety
	Whatever is needed

*12.

Question - Required - We suggest that clubs host a total of two fundraisers during the year. What type of fundraiser are you interested in? (Check all that apply)

	Bake Sale
	Car Wash
	Dress Down Day
	Walk/Run
	Photo Shoot
	Restaurant Fundraiser
	Trivia Night
	Candy Grams
	Other

*13.

Question - Required - How did you hear about Save the Children School Clubs?

*14.

Question - Required - I acknowledge that my Save the Children club is an independent, student-run group that raises awareness and funds to support the work of Save the Children. Consent is hereby given to use club members picture, portrait, likeness in any media, including but not limited to the internet for editorial, educational, promotional and advertising purposes.