Name of School or Organization*

Address*

Street Address Address Line 2 City State ZIP Code

Please include classroom number if applicable

Email*

Phone

Class info, grade level, and expected number of participants

Please note that we require at least 5 participants to do a presentation.

Middle/High School

Puberty
Birth Control
Sexually Transmitted Infections
Sexual Decision Making
Sexual Orientation & Gender Identity
Healthy Relationships
Other

Select the presentation(s) you're interested in. note that we typically devote one session or class period (approx 50 minutes) to each topic; if you select multiple topics, please ensure there are multiple or sufficiently long sessions.

Ideal date range & time of class(es)

Let us know when you're hoping to do this presentation. Please keep in mind that we ask for at least 2 weeks notice in order to give adequate time for planning.

Is there anything else you'd like us to know, or questions you have?

Payment

Yes, we can pay $75 per presentation
No, we don't have the ability to pay at this time
We can make a partial payment

Each presentation cost an average of $100. We ask for a payment of $75 per class to help offset these costs. However, payment in any amount is welcome, and we will present regardless of ability to pay. Do you have the ability to offset the presentation cost?

Request a presentation for young people

Request a presentation

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Annex Teen Clinic