Request the Program

Please fill out and submit this form when requesting the PlastiVan® or the PlastiVideo™ program. Please allow 2 business days for a response.

First Name: *

Last Name *

Email *

Phone Number *

School Name *

School Address *

School City *

School State *

School Zip Code *

Which PlastiVan program do you want? *

Grade Level *

Approximate date you want to start the program *

Approximately how many students will use the program? *

What are you currently studying or planning to study? (To choose multiple options hold control key [mac users - use command key]) *

If Other above:

How long are your class periods? *
(Maximum characters: 2000)
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How did hear about our program? *

If Other above:

Additional Comments:
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No matter where you work in the plastics industry value chain-whether you're a scientist, engineer, technical personnel or a senior executive-nor what your background is, education, gender, culture or age-we are here to serve you.

Our members needs are our passion. We work hard so that we can ensure that everyone has the tools necessary to meet her or his personal & professional goals.