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Section 1 of 3
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Educator
Parent or Guardian
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Email
Phone
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Section 2 of 3
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This workshop is intended for a classroom setting
This workshop is intended to be a part of a larger event
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1.
Early Learning (ages 3-6)
2.
Elementary (grades 1-4)
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Middle Grades (grades 5-8)
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High School (grades 9-12)
5.
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<10
10-20
>20
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Fine Arts (Theatre, Music, Dance, Visual Arts)
Language Arts
Mathematics
PE and Health
Science
Social Sciences
Technology
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Section 3 of 3
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School Day (8am - 1pm start)
After School (2pm - 5pm start)
Evenings (after 5 pm start)
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Yes, I am flexible with my scheduling
No, I have a fixed date
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Title
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My name is
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I am a(n)
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My phone number is:
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My email address is:
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I prefer to be contacted by:
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Tell Us About Your Workshop
Which one applies to your workshop?
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How old are your participants?
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How many are expected to attend?
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Curriculum Connections (check all that apply)
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Upload up to five (5) supporting materials that we can use to help customize your experience (lesson plans, presentations, images, videos, audio).
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Anything else we need to know?
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Scheduling
When would you like to hold your workshop?
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Which time(s) of day work for you?
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Are you flexible with your scheduling?
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If yes, please provide us with a couple of alternate dates
Alternate Date One
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Alternate Date Two
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