* RequiredGeneral Information
Which of the following best describes your school? *
Select your answer Public School Funded Private School Non-Funded Private School Manitoba First Nations School Institutional School Schooling at home Other
School name: *
School Division: *
Select your answer N/A Beautiful Plains School Division Border Land School Division Brandon School Division Evergreen School Division Flin Flon School Division Fort La Bosse School Division Division Scolaire Franco-Manitobaine Frontier School Division Garden Valley School Division Hanover School Division Interlake School Division Kelsey School Division Lakeshore School Division Lord Selkirk School Division Louis Riel School Division Manitoba First Nations School System Mountain View School Division Mystery Lake School Division Park West School Division Pembina Trails School Division Pine Creek School Division Portage La Prairie School Division Prairie Rose School Division Prairie Spirit School Division Red River Valley School Division River East Transcona School Division Rolling River School Division Seine River School Division Seven Oaks School Division Southwest Horizon School Division St. James-Assiniboia School Division Sunrise School Division Swan Valley School Division Turtle Mountain School Division Turtle River School Division Western School Division Whiteshell School Division Winnipeg School Division Other
School phone: *
School Email: *
School Address: *
City/town: *
Postal code: *
School Website: *
Principal name: *
Principal’s phone: *
Principal’s email: *
Is the shipping address the same as the school address? * Yes No
Program Lead Information
When registering for the program, each school is asked to provide contact information for one person who will be a point of contact throughout the school year. School social workers, psychologists or guidance counsellors may take on the role of being the Program Lead. The role of the Program Lead is to be the leader and mental health champion for Thrival Kits in their school. They will be able to answer any questions about the program, and can offer more hands-on support. Please assign a Program Lead below.
Program Lead’s name: *
Role in school: *
Phone number: *
Email: *
Program Lead for: School named above only Entire School Division
Would your Program Lead like a Facilitator Kit? * Yes No/will use kit from last year
How would you Program Lead like to go through orientation? * Virtual session YouTube No thank you
Availability date for orientation: *
Select your answer October 19 October 26 November 2 November 9 November 16 November 23 November 30
Facilitator Information
Please list the names and emails of the educators who will facilitate the delivery of the Thrival Kits™ program this year. An orientation is provided for all individual facilitators. The choice to go through orientation is offered through attending a virtual session or through YouTube.
NOTE: Program Leads, please determine when and what way best suits orientation for facilitators to attend before registering.
Facilitator name: *
Facilitator email: *
Does this facilitator need a facilitator kit? * Yes No/will use kit from last year
How would this facilitator like to go through orientation? * Virtual session YouTube No thank you
Availability date for orientation: *
Select your answer October 19 October 26 November 2 November 9 November 16 November 23 November 30
Add another facilitator? * Yes No
Thrival Kits Order Information
In order to remain consistent with the fidelity of the program, only Manitoba students in Grade 4, 5, and 6 can enroll in Thrival Kits™. because Thrival Kits™ build on the relationships between students and their main classroom teacher, Thrival kits™ is facilitated by classroom teachers.
Indicate the approximate number of students who will be using Thrival Kits™ below:
Number of Grade 4 students: *
Number of Grade 5 students: *
Number of Grade 6 students: *
Estimated total number of students expected to use Thrival Kits in 2023-2024: *
Which language is preferred (please check one): * English French
Total number of classrooms enrolling: *
Expected total number of Thrival Kits™ facilitators (classroom teachers): *
Following submission of the Thrival Kits™ order, a confirmation email will be sent to the Program Lead. Reply to the confirmation email within 3 business days to adjust the order. If there are no adjustments necessary, you do not need to reply to the confirmation email.
Additionally, all facilitators identified will receive their confirmation for orientation, YouTube link (if applicable), kit delivery and their access information to the online portal.
