Stand for the Second School Registry
Please fill out this brief form so that we can catalogue all of the participating schools. Make sure to stay in touch by frequently checking the Twitter (@standsecond) or website for updates.
* Required
Email address
*
Your email
First Name
*
Your answer
Last Name
*
Your answer
Are you a student, parent/legal guardian, or teacher/administrator?
*
Student (confirm you are 13 years or older, if younger than 13 have your parents sign up)
Parent/Guardian
Teacher or School Administrator
Other:
Your Grade
*
College
High School Senior - 12th grade
High School Junior -11th grade
High School Sophomore - 10th grade
High School Freshman - 9th grade
Middle School (at least 13 years old or older)
School Name
*
Your answer
School Street Address
*
Your answer
School City
*
Your answer
School State
*
Your answer
School ZIP Code
*
Your answer
Your Phone Number
*
Your answer
May we send you text messages occasionally?
*
Yes
No
Your Reason for Involvement
Your answer
Twitter ID
Your answer
Instagram ID
Your answer
Other social media ID
YouTube, Snapchat, Facebook, etc.
Your answer
Your Home Address
*
We need this to ship supplies. We will not list it publicly.
Your answer
Your Home City
*
Your answer
Your Home State
*
Your answer
Your Home Zip Code
*
Your answer
Roughly how many students attend your high school?
*
This will help us determine how best to spread the word at your school.
Your answer
Time of your walkout
*
YOU CAN CHANGE THE TIME LATER IF NEEDED. Suggested time is 10 am local time. NOTE: We do not want walkouts to interfere with any schoolwide standardized testing. You may need to adjust the time for what works best for your school. We want to help make your voices be heard, but we do not want to negatively impact testing that you and your classmates have spent the entire year preparing to take.
Your answer
Send me a copy of my responses.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms