Todays Date:
Teacher:
E-Mail:
Teacher Phone:
Other Number:
Fax Number:
Best Time To Call:
Name Of School:
School Address:
Room Number:
Presentation Date:
Number Of Presentations:
Period Times:
Request Ethnicity:
Gender:	female male
Principal Approved:	yes no
Parent Consent Form:	yes no
Restrictions On Subject:
Notes:

Please do not allow other classes to join your Positive Speaking Presentations. If onother teacher would like to have a Positively Speaking presentation please refer them to this request form or give them the PDF form to fax. Presentations may include two speakers. Allow up to half hour for each speaker and help us observe the one class per presentation, per period policy.