Request a Mojave Max Assembly
Please fill out the form in its entirety. Include your name in the "Attending Teacher Information" if you are the person responsible for completing the form, but will also have students attend the assembly.
 
School Information
Name of School *
Address of School*
City * Zip Code *
 
Requestor's Contact Information
First Name * Last Name *
Email * Confirm Email
Phone * Extension
 
Principal's Contact Information
First Name * Last Name *
Email * Confirm Email
Phone * Extension
 
Office Manager's Contact Information
First Name * Last Name *
Email * Confirm Email
Phone * Extension
 
Attending Teacher Information
Please provide the name(s) of all teachers attending the assembly and the number of students in each class. INCLUDE YOUR NAME if you are the person responsible for completing the form, but will also have students attend the assembly.
Add
 
Total Number of Students
 
Assembly Dates
PLEASE MARK A MINIMUM OF THREE DATES THAT ARE ACCEPTABLE FOR AN ASSEMBLY. Feel free to mark as many dates as possibly that are acceptable for an assembly at your school.
 
Please mark a minimum of three dates.*
Thursday, November 16, 2023
Thursday, November 30, 2023
Thursday, December 7, 2023
Thursday, December 14, 2023
Thursday, January 4, 2024
Monday, January 8, 2024
Thursday, January 11, 2024
Thursday, January 18, 2024
Thursday, January 25, 2024
Thursday, February 1, 2024
Thursday, February 8, 2024
Thursday, February 15, 2024
Thursday, February 22, 2024
Monday, February 26, 2024
Thursday, February 29, 2024
Monday, March 4, 2024
Thursday, March 7, 2024
Thursday, March 21, 2024
Thursday, March 28, 2024
Thursday, April 4, 2024
Thursday, April 11, 2024
 
Assembly Checklist
Please ensure all items have been considered and/or will be provided on the day of the assembly.
 
Please carefully read and check all statements.*
I have received permission from the school Principal to have a Mojave Max Assembly
I understand that photos will be taken during the assembly and may be posted on Mojave Max’s social media accounts. Students participating in the assembly should have a signed publicity release form on file with the school. This form is typically given to the parent or guardian at the beginning of the school year. For those instances where you’re unable to verify a signed publicity release form for a particular student(s), please seat them together on one side of the room to ensure their photos will not be inadvertently taken.
I have informed front office staff that an assembly will be taking place and the date of the assembly
I have secured a multi-purpose room large enough to accommodate the assembly
I have ensured that the following equipment are set up for the Mojave Max team: a projector (preferably LCD), a projector screen, a laptop     computer where the Mojave Max Assembly flash drive can be plugged in, a microphone, speakers
I understand the assembly will start promptly at 9:30 AM, last for approximately one hour, and that students need to be seated in the multi-purpose room no later than 9:25 AM
I have ensured the multi-purpose room is set up and available for the Mojave Max team who will arrive at 8:30 AM
I understand someone from the Mojave Max team will contact me via phone to discuss assembly logistics prior to the assembly
I understand that I will be receiving an assembly evaluation following the assembly
 
Please explain how your students would benefit from a Mojave Max assembly.*