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2022/2023 Classroom Program Request Form

  1. CCWD's Water Education Program has returned to an in-person format for the 2022/2023 school year.

    This form serves two purposes:

    1. To sign up for a Classroom Program for the 2022/2023 school year.
    2. To provide feedback on in-person program accommodations.  

    Please note: 

    • Classroom Programs are available for 3rd, 4th, and 5th grade classes. 
    • Programs are offered on a first come, first served basis. 
    • A limited number of virtual programs are available upon request.
  2. Teacher Information

  3. Are you signing up for multiple teachers?*
  4. School Information

  5. Is your school a Title I school?*
  6. Scheduling Information


    Our goal is to reach multiple classes in a day when possible. Please coordinate with other teachers on scheduling.

  7. For virtual programs, we have found it beneficial for learning to cap virtual classroom programs to no more than 40 students, so if you have four grade-level classes, we recommend four classroom programs.

  8. Preferred months of the school year
  9. Preferred days of the week
  10. Please be as specific as possible, keeping bell schedules in mind. Having specific timeslots (e.g. 8:30am-9:45am) allows us to offer multiple programs a day without large breaks at a single school.

  11. Are you requesting an in-person or virtual program?*

    Only one classroom program is available per class per school year; either one virtual program or one in-person program.

  12. We ask that you make our instructors a temporary host on your account so they can conduct the program, share their screens, etc.

  13. How will students participate?*
  14. Accommodation Information

  15. Key Points
    • You will be contacted by CCWD to schedule programs.
    • Questions about scheduling or programs? Email CCWD Water Education.
    • Program duration is 75 minutes.
    • Please select the option to email yourself a copy for your records below and submit the form.
  16. Leave This Blank:

  17. This field is not part of the form submission.