ACR Materials Mobile Request

Name of school

Your first name

Your last name

Your email

please enter the best email to reach you at

Your phone number

please enter your phone number, not the one of the school

What is your role at the school?

Street address of school

City of school

School zip code

What grade(s) are served by the school?

select all that apply

Would you like to apply for a scholarship to cover the visit fee?

The visit fee is a flat $325 to cover the costs of bringing the Materials Mobile to your school. It is typically paid by the school, PTA, or other school support organizations. All materials are included in this fee, so there is no added cost to teachers. However, we don't want this to be a barrier for your school, so we encourage you to apply for a scholarship to cover part or all of the visit fee if needed. Let us know if you'd like to apply and we will send you the scholarship application in a separate email.

What is your preferred date for a visit from the ACR Materials Mobile?

What is your second choice of date for a visit from the ACR Materials Mobile?

What time of day would like the Materials Mobile to visit?

select all that apply

How many people at the school do you think would utilize the Materials Mobile?

please estimate to the best of your ability

What materials are needed most at your school?

e.g. lined notebook paper, 3-ring binders, pencils, etc.

Anything else you'd like to share with us about your school or scheduling preferences/restrictions?

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