Achievement Award Application

To receive Urban Xtreme Achievement Awards for your school, complete the application below and we will be in contact soon *Required

School Name*
Postal Address*
Line 1 Line 2 City State / Province / Region ZIP / Postal Code
Street Address*
Same as Postal Address

Line 1 Line 2 City State / Province / Region ZIP / Postal Code
Information about the behavioural/rewards program*
Briefly explain how the awards will be utilised to help your students
How many awards do you estimate you will need for your program in a 6 month period?*
What age group will the awards be used for?*
DD slash MM slash YYYY
Start Date*
DD slash MM slash YYYY
Any other information you would like to share about your school*
Include information on fetes, fundraising or other events that Urban Xtreme may be interested in supporting
Contact #1*
Name Role
Contact #1*
Phone Email Preferred Contact Method & Time
Contact #2
Name Role
Contact #2
Phone Email Preferred Contact Method & Time
- Yes, I would like to receive news, exclusive offers and specials from Urban Xtreme