Be the Voice: Awareness Events

Complete this form to share how you plan to raise awareness about childhood apraxia of speech. Choose to receive resources digitally for free or by mail for a small fee. Apraxia Kids will follow up after submission.

First Name *

Last Name *

Address *

Address

City

State/Province

Zip/Postal

Country

Phone *

Email *

Is this your first interaction with Apraxia Kids? *

How would you describe yourself? *

How best would you describe your community? *

Suburban

Rural

Metropolitan Area

What is your relationship to apraxia? *

Event Information

To better serve you, please provide a brief description of your awareness ideas, including the event type, intended audience, and estimated reach. *

If your event is on a particular day, please provide the date:

Would like information on how to join the Walk for Apraxia?

Yes

No

Order a Kit

Select the resources you wish to receive to enhance your awareness efforts:

Digital Only Awareness Event Kit (FREE)

I would like to order a kit/additional materials for a fee

The Digital Only Awareness Event Kit is emailed for free and includes:

A PDF of the Digital Event Kit Planner – downloadable & printable resources to:
- Explain & Educate Your Community about CAS
- Engage with your Audience
- Support & Market your event
A PDF of Talking Points about CAS and Apraxia Kids
Guidance and feedback from an Apraxia Kids staff member

The Awareness Event Kit is offered for a small fee to cover the costs of materials and shipping. This kit includes:

All resources in the Digital Only Awareness Event Kit
Awareness Rack Card (QTY: 20) - informational cards to help others understand why talking is hard for children with apraxia
New to Apraxia Brochures (QTY: 10) - trifold brochures with resources and tips on how best to support children with apraxia of speech
“I Made the Choice to Be the Voice” Stickers (QTY: 30) - pass out for others to wear at your event

Do you reside in the United States?

Yes, $15 USD

No, $30 USD

Optional Add-Ons

Will your awareness efforts require brochures beyond the number provided in the basic kit? Further customize and enhance your kit by adding the following resources. These will be in addition to the items you receive above.

IGNORE

IGNORE: $5.00

Blue Apraxia Kids Rubber Bracelets - Pack of 5 for $5.00

Please select the Rubber Bracelet size you prefer:

Adult Only

Youth Only

Mix of Adult and Youth

IGNORE

IGNORE: $2.50

Awareness Rack Cards - Pack of 10 for $2.50

IGNORE

IGNORE: $2.50

New to Apraxia Brochures - Pack of 10 for $2.50

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IGNORE: $2.50

Free Resource Flyers - Pack of 10 for $2.50

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IGNORE: $2.50

Parent Portal Flyer - Pack of 10 for $2.50

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IGNORE: $2.50

Stickers - Pack of 30 for $2.50

Point of Sale Paper Stars – FREE Optional Add-on

Create your own star wall display or partner with a local business, school, or organization to help! Invite others to make a small donation. In return, write their name on a paper star and display it in a hallway, on a door, in a window, on a wall, or wherever others can see!

Would you like Paper Stars to create your own star wall and your goal size. *

No - I do not want to make a star wall

Yes - 25 stars to make a small display

Yes - 50 stars to make a medium display

Yes - 100 stars to make a large display

Additional Information

I would like to make a donation to help support the Be the Voice program and other resources available by Apraxia Kids.

I would like to receive email communication from Apraxia Kids.

Please contact me to discuss options for hosting a fundraiser as part of my awareness efforts.

Total

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