Teen ADMYRE Online/Kit Request

Thank you for your interest in PIAL's dating violence awareness program, Teen ADMYRE.

ADMYRE stands for Advocating for My Relationships.

Please fill out this form to determine which version of ADMYRE would be the best fit.

Which version of Teen ADMYRE would you prefer?*

In-Person Kit: Includes all materials and instructions to facilitate Teen ADMYRE in person to students/youth, mailed in large box.

Online: Receive access link to 100% virtual program that could be shared with students/youth to complete on a computer/laptop or iPad.

Do you have the technology required for the Online version of Teen ADMYRE?*

(1:1 computers/laptops or iPads, and headphones/earbuds)

Since you indicated you do NOT have the required technology, would you be interested in the Teen In-Person Kit?*
Do you have a large space AND several people to run the in-person simulation/program?*
Include optional Spanish translation materials in your Teen ADMYRE Kit?*
Since you indicated you do NOT have a large space and people to run the in-person simulation, would you be interested in the Online version of Teen ADMYRE?*
Do you have the technology required for the Online version of Teen ADMYRE?*

(1:1 computers/laptops or iPads, and headphones/earbuds)

Do you have a large space AND several people to run the in-person simulation/program?*
Include optional Spanish translation materials in your Teen ADMYRE Kit?*

If you change your mind, reach out to us at pial@iastate.edu.


THANK YOU!

If your space or technology needs change, reach out to us at pial@iastate.edu.


THANK YOU!

If you are within Iowa, the PIAL team could facilitate an in-person session of Teen ADMYRE for your school/organization. If you are interested in the PIAL team facilitating Teen ADMYRE at your school/organization, contact us at pial@iastate.edu.


If you are not located in Iowa and you change your mind about using the Online option, reach out to us at pial@iastate.edu.


THANK YOU!

Which Online version of Teen ADMYRE would you like to use?*
Are you willing to participate in the program evaluation that is part of the Teen ADMYRE program?*

This includes having your students/youth complete a pre and post survey electronically and then the data collected and analyzed by Iowa State University. The results will be shared with you.

ADMYRE User Agreement

To use PIAL's ADMYRE program, I agree to not alter the content of the materials and follow the instructions as prescribed by the PIAL team. I agree to have my students/youth participants complete the ADMYRE pre and post surveys.

Enter your first and last name to sign this agreement.

If you change your mind, reach out to us at pial@iastate.edu.


THANK YOU!

Thank you for your interest in ADMYRE. We look forward to having you use Teen ADMYRE with your students/youth.

You will be receiving an email soon with more details.

If you change your mind about participating in the Teen ADMYRE program evaluation, reach out to us at pial@iastate.edu.


THANK YOU!

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