First Name *

Last Name *

What is your position? *

eg:
Grade 5 Teacher, Librarian, Administrator, etc.

Email Address *

Cell Phone *

For emergency use only.
eg: last-minute schedule changes.

School Name *

School Address *

Community/City *

Postal Code *

School Phone Number *

What is your school's affiliation? *

Which division?

Which program are you applying for? *

Win With Wellness

Rider Reading Program

Would your school consider participating in the other program? *

Please list the class(es) participating in the programs and number of students in each: *

eg:
Grade 1 Class, Rider Reading - 25 students

What is the daily bell schedule at your school? *

eg:
8:50-10:10 - Classes
10:10-10:25 - Recess
10:25-11:45 - Classes
11:45-12:45 - Lunch
12:45-2:05 - Classes
2:05-2:20 - Recess
2:20-3:40 - Classes

Are there any extra details about your school and/or class that you can share with our Game Changer Player Ambassadors?

How did you learn about our programs? *

Please specify:

Saskatchewan Roughrider Foundation School Program Application Form