Заявка на семинар для учителей химии на тему «Конструирование современного урока и внеурочной деятельности по химии»
Form description
Прошу зачислить меня слушателем курсового мероприятия Сроки проведения курсовой подготовки: 25 сентября – 27 сентября 2018 г.
Email*
Valid email
Фамилия Имя Отчество
*
Question
Фамилия Имя Отчество
*
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
New
Multiple choice grid
Checkbox grid
Date
Time
Description
Loading image…
Caption
Short answer text
Response validation has been added.
Remove
Number
Text
Length
Regular expression
Greater than
Greater than or equal to
Less than
Less than or equal to
Equal to
Not equal to
Between
Not between
Is number
Whole number
Number
and
Number
Custom error text
Answer key
(0 points)
Loading...
Loading…
Электронная почта
*
Question
Электронная почта
*
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
New
Multiple choice grid
Checkbox grid
Date
Time
Description
Loading image…
Caption
Short answer text
Response validation has been added.
Remove
Number
Text
Length
Regular expression
Greater than
Greater than or equal to
Less than
Less than or equal to
Equal to
Not equal to
Between
Not between
Is number
Whole number
Number
and
Number
Custom error text
Answer key
(0 points)
Loading...
Loading…
Район
*
Question
Район
*
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
New
Multiple choice grid
Checkbox grid
Date
Time
Description
Loading image…
Caption
1.
Бежаницкий
2.
Великолукский
3.
Гдовский
4.
Дедовичский
5.
Дновский
6.
Красногородский
7.
Куньинский
8.
Локнянский
9.
Невельский
10.
Новоржевский
11.
Новосокольнический
12.
Опочецкий
13.
Островский
14.
Палкинский
15.
Печорский
16.
Порховский
17.
Плюсский
18.
Псковский
19.
Пустошкинский
20.
Пушкиногорский
21.
Пыталовский
22.
Себежский
23.
Струго-Красненский
24.
Усвятский
25.
г. Великие Луки
26.
г. Псков
27.
Другой регион
1.
Other…
28.
Add option
or
add "Other"
…
Answer key
(0 points)
Loading...
Loading…
Место работы
*
Question
Место работы
*
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
New
Multiple choice grid
Checkbox grid
Date
Time
Description
Укажите Вашу образовательную организацию
Loading image…
Caption
Short answer text
Response validation has been added.
Remove
Number
Text
Length
Regular expression
Greater than
Greater than or equal to
Less than
Less than or equal to
Equal to
Not equal to
Between
Not between
Is number
Whole number
Number
and
Number
Custom error text
Answer key
(0 points)
Loading...
Loading…
Должность
*
Question
Должность
*
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
New
Multiple choice grid
Checkbox grid
Date
Time
Description
Loading image…
Caption
Short answer text
Response validation has been added.
Remove
Number
Text
Length
Regular expression
Greater than
Greater than or equal to
Less than
Less than or equal to
Equal to
Not equal to
Between
Not between
Is number
Whole number
Number
and
Number
Custom error text
Answer key
(0 points)
Loading...
Loading…
Преподаваемый предмет
*
Question
Преподаваемый предмет
*
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
New
Multiple choice grid
Checkbox grid
Date
Time
Description
Укажите основной предмет
Loading image…
Caption
География
Экономика
Other…
Other…
Add option
or
add "Other"
…
Answer key
(0 points)
Loading...
Loading…
Преподаваемый предмет (совмещение)
*
Question
Преподаваемый предмет (совмещение)
*
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
New
Multiple choice grid
Checkbox grid
Date
Time
Description
Укажите совмещаемые предметы
Loading image…
Caption
География
Экономика
Биология
Химия
Other…
Other…
Add option
or
add "Other"
…
Select at least
Select at most
Select exactly
Number
Custom error text
Answer key
(0 points)
Loading...
Loading…
Образование
*
Question
Образование
*
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
New
Multiple choice grid
Checkbox grid
Date
Time
Description
Loading image…
Caption
Высшее
Среднее специальное
Other…
Other…
Add option
or
add "Other"
…
Answer key
(0 points)
Loading...
Loading…
Какое учебное заведение закончили
*
Question
Какое учебное заведение закончили
*
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
New
Multiple choice grid
Checkbox grid
Date
Time
Description
Наименование вуза или др.
Loading image…
Caption
Long answer text
Length
Regular expression
Maximum character count
Minimum character count
Number
Custom error text
Answer key
(0 points)
Loading...
Loading…
Год окончания учебного заведения
*
Question
Год окончания учебного заведения
*
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
New
Multiple choice grid
Checkbox grid
Date
Time
Description
Например, 2012
Loading image…
Caption
Short answer text
Response validation has been added.
Remove
Number
Text
Length
Regular expression
Greater than
Greater than or equal to
Less than
Less than or equal to
Equal to
Not equal to
Between
Not between
Is number
Whole number
Number
and
Number
Custom error text
Answer key
(0 points)
Loading...
Loading…
Педагогический стаж работы
*
Question
Педагогический стаж работы
*
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
New
Multiple choice grid
Checkbox grid
Date
Time
Description
Loading image…
Caption
Short answer text
Response validation has been added.
Remove
Number
Text
Length
Regular expression
Greater than
Greater than or equal to
Less than
Less than or equal to
Equal to
Not equal to
Between
Not between
Is number
Whole number
Number
and
Number
Custom error text
Answer key
(0 points)
Loading...
Loading…
Подтверждение
*
Question
Подтверждение
*
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
New
Multiple choice grid
Checkbox grid
Date
Time
Description
Loading image…
Caption
Разрешаю использовать вышеуказанные данные для обработки в автоматизированной информационной системе «Педагогические кадры Псковской области»
Other…
Add option
or
add "Other"
…
Select at least
Select at most
Select exactly
Number
Custom error text
Answer key
(0 points)
Loading...
Loading…
Link to Sheets
The number of responses collected by this form may exceed the limit supported by Sheets. If you're having trouble viewing your responses in Sheets, try downloading a .CSV instead.
Message for respondents
This form is no longer accepting responses
Summary
Question
Individual
Insights
Total points distribution
Loading...
Loading responses…
This form is approaching the response limit. Once surpassed, the summary of responses will no longer be displayed. Learn more
Close
This form has exceeded 50,000 responses and the summary of responses can no longer be displayed. You can still download responses as a .csv file. Learn more
Фамилия Имя Отчество
Copy chart
No responses yet for this question.
Электронная почта
Copy chart
No responses yet for this question.
Район
Copy chart
No responses yet for this question.
Место работы
Copy chart
No responses yet for this question.
Должность
Copy chart
No responses yet for this question.
Преподаваемый предмет
Copy chart
No responses yet for this question.
Преподаваемый предмет (совмещение)
Copy chart
No responses yet for this question.
Образование
Copy chart
No responses yet for this question.
Какое учебное заведение закончили
No responses yet for this question.
Год окончания учебного заведения
Copy chart
No responses yet for this question.
Педагогический стаж работы
Copy chart
No responses yet for this question.
Подтверждение
Copy chart
No responses yet for this question.
Waiting for responses
of
12
This form is approaching the response limit. Once surpassed, the question view will no longer be displayed. Learn more
Close
of
1
Loading...
Loading response…
This form is approaching the response limit. Once surpassed, the individual view will no longer be displayed. Learn more
Close
Grades from previous versions of this form are hidden. Learn more
Settings
Release grades
Respondent settings
Global quiz defaults
Default question point value
Point values for every new question
points
Responses
Manage how responses are collected and protected
Collect email addresses
Required by Locked mode
Do not collect
Verified
Responder input
Send responders a copy of their response
Disabled by Locked mode
Requires Collect email addresses
Off
When requested
Always
Requires sign in
File upload
Total size limit for all uploaded files
This limit is smaller than the max size of a single response.
Responses will not be accepted after the limit is reached. Learn more
1 GB
10 GB
100 GB
1 TB
Presentation
Manage how the form and responses are presented
Form presentation
After submission
Confirmation message
Спасибо!
Ваша заявка принята. О решении по зачислению будет сообщено по электронной почте Вам и в муниципальный орган управления образованием.
Руководитель курсов ***
Контакты: г. Псков, ул. Гоголя, 14. тел. 8(8112)66-34-27,
e-mail: terestatyana@yandex.ru
Сайт http://poipkro.pskovedu.ru