School Name *

School Mailing Address *

Grade Levels Served

Teacher/Staff Member Name *

This should be you, the teacher or staff member who will lead the group.

Teacher/Staff Member Email Address *

Teacher/Staff Member Phone *

Best Time & Method to be Contacted

Is this club NEW or already EXISITING? *

Enter required value New Existing

If NEW

Please tell us about your club. Include information such as 

• Planned start date
• Anticipated number of students
• Meeting frequency (weekly, biweekly, monthly, etc.)
• Does the sponsor/leader have crochet experience? 
• Has any funding or supplies already been secured? If so, from where and how much?

If EXISTING

Please tell us about your club. Include information such as

• How long has the club been running?
• Current number of active members
• Meeting frequency
• What supplies do you currently have on hand? 
• Can your club use yarn beyond basic smooth worsted-weight or bulky-weight acrylic? 

Yarn preference *

For new clubs we try to provide smooth worsted or bulky weight yarn since it is considered the best for new crocheters. We do occasionally have other weights and types of yarn that we can provide. 

We have mostly new crocheters; we need smooth worsted or bulky weight yarn

We can use other weights and types of yarn.

Is there anything else you would like us to know?

a specific request or need, a way the projects are utilized, etc

Terms of Donation *

In return for the supplies, CGOA requests 

• 3 to 4 hi resolution photos of students using the supplies (can be a close up of the hands to maintain student privacy) or items the students have made. I agree to provide these photos within 6 weeks of either receipt of material or club start date (whichever is later). CGOA will have permission to use these photos in perpetuity.
• permission to list the name of the school as a school with a crochet club assisted by CGOA donations.

Please type your name to acknowledge agreement ,and that you have secured any of the necessary permissions for this agreement from your administration.