zMAD Interest Survey
We are looking for at least 8 High Schools and 8 Middle Schools to participate in the program. If you are interested in being part of the zMAD Leadership Experience, please fill this survey out.
Name of School *
Your answer
Type of School *
Required
Main School phone number *
Your answer
Total School Enrollment *
Your answer
School Contact Person: *
Your answer
School Contact Person (phone number) *
Your answer
School Contact Person (email address) *
Your answer
Does the school have a formal ASB/Leadership Team? *
ASB/Leadership Team Advisor Name (Teacher or Staff member assigned to your school’s team) *
Your answer
ASB/Leadership Team Advisor email (Teacher or Staff member assigned to your school’s team) *
Your answer
Anticipated Roster Size: 5 ($2500) More than 5 ($500/additional participant, max 7) *
Does the school have a viable Student Survey tool to use? *
Is the school interested in using a Student Survey provided by zMAD? *
Current School Culture Issues/Challenges for administration (Top 3) *
Required
ASB Activities that you would like to add that will improve school culture *
Required
On a scale of 1-10 how interested are you in participating in this program? *
What would prevent you from participating in this program? *
Your answer
What questions do you have for us? *
Your answer
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