KPA Class Order Supply Form

We’ve got your workshop supplies—just fill out this form and send it in!

This form will be e-mailed automatically to [email protected]) when you select Submit at the bottom of this page.
Please submit your request for workshop paperwork and forms a minimum of three weeks prior to your Workshop start date, preferably sooner.
Please submit your request for Certificates of Completion and party packs a minimum of three weeks prior to your final Workshop, preferably sooner.
If you need to amend your request after it has been submitted, send an e-mail to [email protected] with the subject line: Amended Supplies Request.
If you want to print and manage your own forms, or if you need supplemental copies of a particular form, please use the KPA Faculty Resource Center.

Instructor Name*
First Last
Instructor Email*
Shipping Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Date Materials Needed*
MM slash DD slash YYYY
Number of Students*
Class Format*
Workshops forms*
- Please send me the complete set of forms for Regional Workshops
- Please send me complete set of forms for a National workshop
- I need something different
If you checked something different above, please describe:
Completion Date for Workshop Certificates*
MM slash DD slash YYYY
Please send Workshop Certificates for the following students*
Please verify spelling of name prior to submission of this form.
Please send replacment soccer cones/discs
Indicate the number needed, if none, put "0"
Please send replacement rope
Indicate the number needed, if none, put "0"
Please send dog gift bags*
- Yes
- No
If yes for dog gift bags, please tell us how many large, medium and small dogs
Please send party supplies:*
- Yes-I need party supplies
- No-I do not need party supplies
Phone
This field is for validation purposes and should be left unchanged.