The Long March to Freedom

School Name

School quintile

Select from school quintile options

School phone

School e-mail

Full physical address of the school

First Name

Last name

Phone number

Email address

Grade of learners

Number of learners

Number of educators

Are the learners studying History as a subject?

Yes

No

Preferred Visit Date:

(Please select a clear day without an event)

Requests & Comments

(For example, Do you require a specific theme for the activity during the visit)

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