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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