Be The Voice- Request a Classroom Awareness Kit

First Name *

Last Name *

Are you located outside the United States / Canada? *

Yes

No

If you are located outside the United States or Canada, someone from Apraxia Kids will be in touch regarding additional shipping charges for international requests.

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? *

What grade is your child in? *

How many children are in your child’s classroom?

How many teachers or aides are in your child’s classroom?

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

Each Classroom Kit includes Being a Great Friend Bookmarks, Stickers, Teacher’s Guides, and your choice of Coloring Pages or Word Searches as a classroom activity. Coloring pages suggested for all ages. Word Search suggested for ages 7+. Please choose which classroom activity you would like to receive: *

Purchase the Classroom Add-on "I Want To Be Your Friend" book for $12 USD? *

Yes

No, thank you.

Purchase the Classroom Add-On Time to Sing CD for $15. *

Yes

No, thank you.

How many people are participating in your event? *

We are excited to offer these kits free of charge to maximize awareness! Would you like to make a donation to help us offset the cost of printing and shipping? *

Donation Amount (USD): *

I would like to receive email communication from Apraxia Kids.

Total (USD):

Be The Voice – Request a Classroom Awareness Kit

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