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Healthy Heart Schools Program
Request Form
School Request Form
Interested in having your school participate? Fill out the form below and Heart Niagara staff will reach out with more information.
School Name
Teacher Name
Email
Phone number
Choose School Period(s)
Period 1
Period 2
Period 3
Period 4
Period Start & End Times (Leave blank for unselected periods)
Period 1
Period 2
Period 3
Period 4
Class Size
Additional information
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