Empowering Educators Interest Questionnaire
First name
Your answer
Last name
Your answer
Occupation
Preferred form of communiation
Phone number
Your answer
E-mail address
Your answer
Professional Affiliation
Your answer
Preferred time to communicate
How did you hear about the Empowering Educators Workshops?
What would you like to gain by attending the workshops?
What are your top three dreams and hopes for education?
Your answer
What are your top three fears and/or concerns for education?
Your answer
How would you like to be involved the Empowering Educators training program?
Do you have any questions, concerns or suggestions that you would like to share with the workshop coordinators?
Your answer
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