Book A Presentation

REQUEST A PRESENTATION

Additional Date/Time options can be discussed when we reach out.

Name *

First

Last

Email *

Email

Confirm Email

Contact Phone Number *

County *

School or Organization Name(s) *

School District *

(enter N/A if not applicable)

Anonymous Reporting Tool Used *

(enter "I don't know" if unsure or N/A if not applicable)

GRADE LEVEL, DATE, AND LOCATION

Presentation style *

Virtual
In-person (Available only in certain areas. See "Students" section above for more detail.)

Please let us know how many attendees for each of the student presentations selected. Enter "0" if none for that grade. After entering attendees, more information will be requested: Number of Presentations and Preferred Date/Time.

Attendees - Kinder-2nd Grades *

Number of Attendees

Presentations - Kinder-2nd Grades *

Number of Presentations

Date / Time - Kinder-2nd Grades *

Date

Time

Additional Date/Time options can be discussed when we reach out.

Attendees - 3rd-5th Grades *

Number of Attendees

Presentations - 3rd-5th Grades *

Number of Presentations

Date / Time - 3rd-5th Grades *

Date

Time

Additional Date/Time options can be discussed when we reach out.

Attendees - 6th-8th Grades *

Number of Attendees

Presentations - 6th-8th Grades *

Number of Presentations

Date / Time - 6th-8th Grades *

Date

Time

Additional Date/Time options can be discussed when we reach out.

Attendees - 9th-12th Grades *

Number of Attendees

Presentations - 9th-12th Grades *

Number of Presentations

Date / Time - 9th-12th Grades *

Date

Time

Additional Date/Time options can be discussed when we reach out.

ADULT PRESENTATION 45-60 MINUTES *

Educator Presentation
Community/Club/Business
NOT Applicable

Date / Time *

Date

Time

Additional Date/Time options can be discussed when we reach out.

Physical Address *

Address Line 1

Address Line 2

City

State

Zip Code

Please let us know how many attendees for each of the adult presentations selected above.

Reason for presentation request (this data helps us understand your presentation needs) *

Educational
Campus experiencing cyberbullying
Professional development (adults)

Does your campus currently have an anti-bullying program and/or club? *

Yes
No
N/A

What outcome(s) would you like to see after hearing the David's Legacy Foundation presentation? (check all that apply) *

Awareness and understanding of Cyberbullying
Awareness and understanding of David's Law
Change in behavior

REQUEST A PRESENTATION

GRADE LEVEL, DATE, AND LOCATION