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* 1. Your name and school address

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* 2. What is your role in the school?

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* 3. Name and email address of Year 5 teachers

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* 4. Name and email of Business Manager

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* 5. How many pupils do you have on roll in the whole school?

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* 6. How many year 5 pupils do you have? 

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* 7. Who would you like the assembly delivered to?

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* 8. Please select up to 3 dates for the visit, numbering them 1, 2 and 3 in order of preference. If none are suitable, please suggest an alternative in the box provided.

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* 9. When would you prefer your assembly and workshops to take place? NOTE: Please select 'Morning' if you have more than 1 year 5 class in order to fit in the year 5 workshops

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* 10. So we can schedule your visit:
If you have chosen a morning visit, when is morning break time and when is KS2 lunch?

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* 11. If you have chosen an afternoon visit, when does lunch finish and is there an afternoon break for KS2? When does the teaching day end?

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* 12. Do you have an Eco Lead member of staff? If so please provide their email address

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* 13. Does your school have an Eco Club? 

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* 14. How did you hear about the Energy Heroes programme?

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* 15. If other, please specify

Thank you very much for completing this expression of interest. A member of our team will be in touch shortly to confirm booking and offer dates for your first visit from the Energy Heroes! If you have any questions in the mean time, please drop us an email at hello@energyheroes.org.uk

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