
                
 
 
                        Custom Programming Request
Complete this questionnaire to help us recommend programming that meets your interests and needs
Name* 
Your Town* 
Email*
                            
                        
Phone*
Group Composition
Anticipated number of children in attendance*
Age/grade of participating children*
# of adult participants (if none, please specify drop-off)*
Desired type of group composition (e.g., your family only; your pod only; mix of others who Sheldrake identifies)*
Scheduling
Preferred program frequency (e.g., daily, twice-weekly, weekly, biweekly, other) **
Preferred days & times*
Program length (e.g., 45 mins, 1 hour, 3 hours, other)*
Duration of program (e.g., 4 weeks, 6 weeks, 12 weeks, full school year, other)*
Around when are you looking to have the program start?*
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Location
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Where would you want the program to take place (e.g., at Sheldrake, in your backyard, other)? Please specify the town if not at Sheldrake.*
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Are you interested in virtual (Zoom) programming?
			
				
				Yes
			
			
				
				No
			
Other
Additional requests, comments, questions?
How did you hear about this program?*