Collaboration Inquiry!
I would love to share and learn with you and your colleagues! Fill out the form below to inquire about collaborating with me on an event!

- Jake

Email address *
Your Name *
Your answer
Your District/School/Organization *
Your answer
Your Title *
Your answer
Your Email *
Your answer
Your Phone Number *
Your answer
Type of event *
Possible Format *
Check all that apply
Required
Describe the audience *
Teachers? Administrators? Pre-service teachers? Students? Elementary? Middle School?
Your answer
Possible Topic(s) *
Check all that apply
Required
Date of Event (First Choice)
MM
/
DD
/
YYYY
Time Range of Event
i.e., 8:00-11:00 AM EST
Your answer
Backup Dates & Times
Your answer
Location of Event
Skip for Webinar/Hangout/Skype
Your answer
Note: there are other details that I'll need once we get this learning party scheduled (i.e., what are the ability levels of the attendees? What grades do they teach? ), but for now - I just need the basics on the event. We'll continue the discussion on the other stuff later!
Message
Are there any important details that Jake needs to know that weren't covered in the above questions? Please provide them here!
Your answer
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms