School Programs Request Form

Please fill out the form to request participation in our School Programs.

Your Name

First Name

Last Name

Your Email Address

Your Phone Number

(###)

###

####

What school do you work at?

What district is your school in?

What is your position at the school?

Check all that apply. Which program would you like to request participation in?

Reward with Chick'n (K-8 Program)

Fundraising with Chick'n (K-12 Program)

Something Else

If you are a teacher expressing interest in the Reward with Chick'n program, how many digital offer coupons would you need for your classroom?

I understand that I will be asked to present my teacher or faculty ID card to verify that I am a current teacher or staff at a school in the local school district as part of this request.

I understand

Anything else? If you have any initial questions or additional comments you need to let us know for your request, feel free to express them here.

Please Read

After pressing submit below, our team will review and process your request and follow up with you via email within 10 business days from time time of your request. Please double check that the contact information you have provided above is correct before submitting your request. At this time, we will not be taking requests in store or over the phone. Our team will be happy to answer any and all questions you have when they follow up with your request. As a reminder, requesting participation in any of our School Programs is not a gaurantee that participation will be accepted. Our desire is to support as many teachers and schools as possible within the local school district, while supplies last.

I have read and understood the above statement

I understand and agree