Crush Diabetes Material Registration

CURRICULUM & MATERIAL REGISTRATION

Welcome! Complete the registration form to gain no-cost access to the CRUSH Diabetes curriculum. Each teacher in a school using the curriculum must complete a separate registration form. Please fill out the entire form to help us with processing your registration. We look forward to having you as a part of CRUSH Diabetes!

If you have any questions, don't hesitate to contact us at nutrition@health.utah.edu

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Contact Us

University of Utah Center For Community Nutrition

Phone: 801.581.6730

Email: nutrition@health.utah.edu

CONTACT INFORMATION

First Name

Last Name

School's name

School District

TEACHING INFORMATION

Grade Taught

Number of classes you teach in Health

Number of students you teach each term in Health

CRUSH DIABETES TEACHING MATERIAL REQUEST

Digital copy of the teaching materials

Yes

Physical copy of the teaching materials

Yes

Address

Address 2

City/Town

State/Province

ZIP/Postal Code