Enrollment Form - Tigger Stavola Foundation

Are you a:*

First Name:*

Student's First Name:*

Student's Last Name:*

Mobile Number:*

Parent/Caregiver’s Mobile Number:*

Gender:

Student's Gender:

What sex was originally listed on your birth certificate?*

What sex was originally listed on your student’s birth certificate?*

Gender Identity:*

Please Specify:

Race and Ethnicity:

Student's Race and Ethnicity:

Race:*

Student’s Race:*

Please Specify:

Ethnicity:*

Student’s Ethnicity:*

How old are you?*

How old is your student?*

How did you hear about the LED by Tigger program?*

You chose "Other", please specify:*

How did you hear about the LED by Tigger program?*

You chose "Other", please specify:*

What education does your school offer about drugs and alcohol?*

What education does your student’s school offer about drugs and alcohol?*

Preferred time of day to receive program’s text messages*

:

Preferred time of day to receive program’s text messages*

:

Parent’s Mobile Number*

(so we can text your parent and inform them that you have signed up for our program)

Additional Feedback: