Eves Fund for Native American Health Initiatives

Sponsoring community programs in injury prevention,
literacy & education for at-risk Native youth

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ThinkFirst Navajo Interest Form

GOAL: To prevent brain, spinal cord, and other injuries on the Navajo Nation
through culturally sensitive and age-appropriate education.

I understand the goal of ThinkFirst-Navajo and I am interested in scheduling a ThinkFirst-Navajo Injury Prevention presentation at my school.

I understand we will be asked to sign a Presentation Agreement as soon as the presentation is scheduled. As part of this agreement, we will provide a large meeting space (i.e. cafeteria, gymnasium) and any necessary A/V equipment as requested.  We will also administer, collect and return any required Pre-Surveys and Post-Surveys, if required by Eve’s Fund.

    *Required

    YOUR INFORMATION

    Name (required)

    Title

    Phone*

    Email (required)

    SCHOOL INFORMATION

    School Name*

    School Address*

    Principal's Name*

    Total Enrollment*

    Grades*

    PRESENTATION INFORMATION

    Three Suggested Dates for Presentation*

    Suggested Schedule - #of groups & times*

    Enter Verification Code

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