Share your story: Action for Healthy Kids

Share Your Story

If you have an exciting story to share about your school’s wellness initiatives, we want to hear about it! Please take a few minutes to complete this survey below. We will review your submission and may publish all or part of your results in newsletters, publications and on our Web site.

Contact Information:


*	First Name: Required
*	Last Name: Required
*	Email: Required
	State / Province:
	Phone Number:
	Yes, I would like to receive e-mail from Action for Healthy Kids.
	Remember me. What's this?

Question - Required - School District:

Question - Required - School Name:

Question - Required - Which of the following best describes the success story you are submitting? Please select all that apply.

	Childhood Obesity
	Food at School
	Health & Achievement
	Healthy School Environments
	Nutrition Education
	Physical Activity
	Physical Education
	Policy Measurement & Evaluation
	Building Awareness & Support

Question - Required - Did you work with any nonprofit or corporate partners on this success?

Question - Required - Which of the following Action for Healthy Kids tools, if any, were used in the development, implementation or evaluation of this success?

	Game On! The Ultimate Wellness Challenge
	ReCharge! Energizing After-School
	Resources to Improve Schools
	Wellness Policy Tool
	Parents Advocating for School Wellness Toolkit
	Students Taking Charge
	We did not utilize these tools

Question - Required - Program Title:

Question - Required - Brief program description:

(Maximum response 255 chars, approx. 5 rows of text)

Question - Required - What impact has it made on your school and children? Please provide specific data (i.e., # of students impacted, grade levels, behavior/attitude/knowledge changes) as well as anecdotal stories (i.e., quotes from students, teachers, etc).