Inquire about MindUP Your InformationName* First Last Your Email* Enter Email Confirm Email Your Professional TitlePhoneOrganization InformationPlease provide us with information about the organization you are inquiring for.Organization Name*Organization Type*SchoolSchool District/ProvinceCommunity OrganizationMental HealthOtherOrganization Type (Other)Please list your organization type.Organization WebsiteOrganization Address* Street Address City State / Province / Region ZIP / Postal Code Country AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe How did you hear about MindUP?*WebsiteColleagueTeacherOtherIs your school district working directly with CASEL?*YesNoPlease tell us where and how you heard about MindUPPlease tell us about your previous experience with MindUP (if any)Please tell us about your previous experience with other SEL Programs (if any)MindUP Service RequestsHow many schools are you requesting MindUP for?Single School/SiteMultiple Schools/SiteDistrict-Wide ImplementationNot SureEstimated number of participating schools?Please enter a number from 1 to 10000.ParticipantsMindUP programming varies depending on factors such as location of training and number of schools and participants involved. In the ‘Participants’ section below, please provide us with an estimate of the number of participants - teachers, staff members, and students - that would be using MindUP curriculum at your organization.Estimated Number of Staff Participants?Please include teachers, support staff, administrators and other adults interested in being trained.Please enter a number from 1 to 100000.Estimated Number of Student Participants?Please indicate the approximate number of students in your school that will receive MindUP lesson.Please enter a number from 1 to 1000000.MindUP Implementation Launch DateMindUP begins with a full day “Day One” Introductory Training.When would you like to begin implementation of MindUP?Spring 2019Fall 2019Spring 2020OtherImplementation Start DateEnter potential start date for MindUP implementation.How flexible are your dates for scheduling this training?Very FlexibleSomewhat FlexibleNot Flexible - my dates are predeterminedAdditional InformationPlease provide any additional information that may be helpful.Additional InformationEmailThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle Ajax powered Gravity Forms.