Start a Club HOPE ChapterReady to Schedule your Club HOPE Meetings?Please complete this questionnaire to help us set up your Club HOPE program. "*" indicates required fields School name*Meeting address*Where your Club HOPE meetings will be held Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Club HOPE leader name* First Last Club HOPE leader email* Club HOPE leader cell phone*Club HOPE leader is a* Parent Teacher Club HOPE co-leader name* First Last Club HOPE co-leader email* Club HOPE co-leader cell phone*Club HOPE co-leader is a* Parent Teacher Location in school where meetings will be held*e.g. gym, classroom, libraryPlease enter 5 dates you would like to hold your meetings*Once monthly meetings occur January through May. Online registration takes place in December.Requested time of your meetings*Provide start and end times (90 minutes)Grades you would like to include*check all that apply Kindergarten First Second Third Fourth Fifth Maximum number of students you would like to facilitate*What is your school mascot and core values*Any special needs and/or requests we need to be aware of in order to ensure the best experience for your group? If not applicable, please enter NONEDo you have any questions about Club HOPE?
