Is this a Primary School? *Please note our focus is PRIMARY schools ONLY *

*Primary school is a school with children aged 5-13 | Grades R to Grade 7.

YES

NO

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Do children attending school have shoes? *

Select One

Some have shoes

Most have shoes

All have shoes

None have shoes

Do children wear a school uniform? *

Yes

No

Please confirm if your school has: *

Tick all that apply

1-3 classrooms

>3 classrooms

Windows - no glass

Windows - glass installed

Electricity - with lights in classrooms

Electricity - but no lights

Toilet Block - Running Water

Toilet Block - No Water

Computers

School Principal Details *

First Name

Last Name

Your Details *

First Name

Last Name