NRES 734 Course Request Form

KEEP has several requests for the NRES 734 course. We schedule courses depending on scholarship availability and interest from the district. Please review the form below. Fill in the information to the best of your ability and click Submit. Once KEEP receives your official request, your district will be added to the waiting list. KEEP will communicate with the person identified as the contact for the district when scheduling the course. If you have any questions, contact Carrie Ziolkowski at cziolkow@uwsp.edu or 715.346.4651.

Name of contact for the district:
Name of school district:
Title (grade/subject if teacher):
Email:
Phone number:

Name of District Administrator/Superintendent:
Email:
Phone number:
Date contacted:
General response to offering KEEP NRES 734 in their district:
Name of school they suggest holding the course/energy assessment:

Name of District Facilities Manager/Building & Grounds Supervisor:
Title:
Email:
Phone number:
Date contacted:
General response to offering KEEP NRES 734 in their district:
Name of school they suggest holding the course/energy assessment:

Name of District's Utilities Representative (Your district Facilities Manager should have this information):
Title:
Name of Utility:
Email:
Phone number:

Names of at least 8 teachers/administrators interested in taking KEEP NRES 734( include school, grade, subject, and title if others than teachers):
1:
2:
3:
4:
5:
6:
7:
8: