Hayfield SS Panel Member Form

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Complete this form to be considered by region leadership to participate on the principal panel for Hayfield Secondary School on Tuesday, March 14, 2023. Region leadership will select four (4) staff, four (4) community members and one (1) student to represent the school.

Participant Information & Requirements:
- FCPS staff will use assigned @fcpsschools.net account.
- Community members will be assigned an @fcpsschools.net account to access Google Drive and Hangout
- Reliable internet, audio (microphone) and video (camera). Region/HR can provide assistance with technology and connectivity.
- Available and free from disruption for the entire panel day 8:00 am – 4:00 pm.
- All interviews should be completed by 4:00 p.m.
- A time for lunch will be provided.

Email *

Name *

In which way will you be representing the school? *

Address

Preferred Phone Number *

Alternate Phone Number

Number of Students Enrolled at School (if applicable)

Age(s) of Student(s) (if applicable)

Subject(s) Taught (if applicable)

Personal or Student Involvement in School Programs,

Would you require language interpretation if selected as a panel member?

Yes

Clear selection

Additional Information

Submit

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