4 - 6 | Page 4 | At My Best

At My Best 456® is a Grade 4 to Grade 6 comprehensive toolkit that addresses physical activity, healthy eating, and the importance of emotional well-being. It was written to support the delivery of the Health and Physical Education curriculum. If you are a school/health unit that teaches Grades 4-6 and are committed to deliver the At My Best program you are welcome to receive this FREE toolkit.

School Info

School Name

Street Address

City

Province

Postal Code

eg. A1A 1A1

School Telephone Number

Kit Info

Grade Levels

Grade 4

Grade 5

Grade 6

Multi-Grade (4-6)

Applicant Info

Applicant's First Name

Applicant's Last Name

Applicant's Email Address

Applicant's Teaching Grade Level

Principal's First Name

Principal's Last Name:

Principal's Email Address

The principal is aware of this application and supports the implementation of At My Best in our school:

Yes

Grade 4 Teacher Info

Grade 4 Teacher

First Name

Last Name

Add another Grade 4 Teacher

1st Additional Grade 4 Teacher

First Name

Last Name

2nd Additional Grade 4 Teacher

First Name

Last Name

Grade 5 Teacher Info

Grade 5 Teacher

First Name

Last Name

Add another Grade 5 Teacher

1st Additional Grade 5 Teacher

First Name

Last Name

2nd Additional Grade 5 Teacher

First Name

Last Name

Grade 6 Teacher Info

Grade 6 Teacher

First Name

Last Name

Add another Grade 6 Teacher

1st Additional Grade 6 Teacher

First Name

Last Name

2nd Additional Grade 6 Teacher

First Name

Last Name

Terms and Conditions

* As a participating teacher(s) in the At My Best program I/we agree to be contacted by PHE Canada or At My Best researchers by phone and/or email to share successes and challenges of the At My Best program, and to allow gathering of best practices and success stories. I/we understand that in some cases honoraria will be provided to those teachers participating in At My Best related-research. Each year research is conducted to allow us to learn how we can continue to enhance the At My Best program.

* En tant que professeur (s ) participant au programme À mon meilleur programme I / nous sommes d'accord pour être contacté par PHE Canada ou à mon meilleur chercheurs par téléphone et / ou par courriel à partager les réussites et les défis du programme À mon meilleur programme , et de permettre la collecte des meilleures pratiques et les réussites . Je comprends / nous comprenons que, dans certains cas, les honoraires seront fournis aux enseignants participant à At My Best- recherche connexe. Chaque recherche de l'année est menée afin de nous permettre d'apprendre comment nous pouvons continuer à améliorer le programme À mon meilleur programme.

Are you willing to be contacted for research purposes?:

Yes

* The take home component is a key aspect of At My Best as it allows children to build on their learning at home with their families. PHE Canada will be approving At My Best kit orders based on schools commitment to delivering the take home component.
* Le composant à retenir est un aspect clé de À mon meilleur , car il permet aux enfants de construire sur leur apprentissage à la maison avec leurs familles . PHE Canada approuvera à mon meilleur commandes du kit basé sur l'engagement des écoles à fournir la composante de prendre la maison .

Are you committed to the take home component?:

Yes

* I/we recognize that there are limited quantities of the At My Best program kit and also recognize the importance of proportional regional dispersement of the At My Best resource across Canada to ensure children in each province and territory have the opportunity to learn from this resource.
* I / nous reconnaissons qu'il ya des quantités limitées de l' At My Best kit du programme et aussi reconnaître l'importance de dispersement régionale proportionnelle de la À mon meilleur ressource à travers le Canada pour assurer aux enfants dans chaque province et territoire ont la possibilité d' apprendre de cette ressource .

Furthermore, I/we understand completion of this application form does not guarantee my school's receipt of the program. :

Yes

How did you hear about AMB?

Comments:

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4 - 6

At My Best 456® Program Application Form

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