Education Request

First Name:

Last Name:
Select Your Location:

Select your type of School:
Select your type of School:

School Email:
(If different than above)

School Website:
Title: Number of Schools Interested
Principal / Head Teacher:

What date would you like The Scary Guy to come
to your event? (leave blank if unsure)
month day year
School Name: Phone Number:
Number of Students:

Grades Attending / Year Group Range


Please type in your Region / State /
Providence / Territory:

Zip Code / Postal Code:
How did you hear about us?

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