Request Form
If you want MIKA to plan a particular event, fill out this form and we will get in touch
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First and Last Name *
How old are you? *
What state do you live in? *
What level of school are you in? *
If you chose Elementary school, middle school, or high school: please specify with Kindergarten or your grade level (01 - 12). If you chose "College" please specify what year your in and your school. If you chose "I work"   please name your company, or your employer's info. If your chose "Other" please explain/specify. *
What school do you currently attend? (and the county) *
What service would you like from us? *
What movement or cause is this to support? *
Your email *
Your phone number *
Any other contact information for the platform
What day(s) would you be available for meetings? *
Required
What time(s) would you be available to have meetings? (Include your time zone) *
Do you prefer using zoom or google meet for our meetings? *
How did you hear about Make-It-Known: Awareness *
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