Below are the questions we ask every teacher so we can better meet your needs as we customize our program to fit you, your students and your school.
Contact Information
Teacher's Name:
Mr. Ms. Mrs.
Your height [sizing purposes]
Grade[s]:
Subject[s]:
Number of Students:
Home Phone #:
Cell Phone #:
E-mail:
Principal’s Name:
School Name:
School Website:
School Address:
Other interested teachers:
How many classroom teachers will be involved?
How many student balls are desired?
Profile
If a text box is provided, please include more information if you feel it would be helpful.
Do you team teach?
Yes
No
Do other students/adults share the room?
Do you have any students with special needs?
What is the set-up of your room? [i.e., small, large, rows, clusters, tables, desks . . . ]
What is your preferred method of presenting information to students?
Are the desks/tables adjustable?
If NO, are they all ONE height?
Provide measurement[s] from floor to under desk/table top for any non adjustable.
Has the principal approved this project?
Is there a Wellness-type initiative in your school/district?
Does the PE teacher in your school want to participate?
Select any of the following funding sources you plan to use:
PTO/PTA
Grant
Wellness/fitness budget for school/district
Local business/business partner
Fundraising
Physical Ed., Special Ed., Classroom and/or school budget
Other:
GRANT INFORMATION [complete the following IF you are writing a grant]
Due date ?
What is the $ limit?
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Is there an air compressor available at your school [check with PE teacher]?
What benefits of sitting on the stability ball are most needed in your classroom?
Improved attention & concentration
Improved posture
Ability to move
Appropriate sizing of student to desk/table
Move & stretch breaks
Other
What is your experience with the stability ball?
Exercise
Sitting
Therapy
Not much experience
What is the best phone number to reach you?
When is the best time to reach you?
How did you hear about WittFitt?
Comments/questions:
Validate Text:
