QCaMP Teacher Registration Form

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First Name *

Last Name *

Preferred Name

Grade/Classes Taught

Estimated number of students taught each year
*

Gender

Email *

Personal Email (gmail, hotmail, etc, for access to google classroom) *

Phone Number *

School *

School District *

Street Address
*

City
*

State
*

Zip Code
*

Preferred Shipping Carrier (optional)

T-shirt Size *

Preferred Location
*

Will you have access to a computer and internet? (for virtual camps)
*

Yes

Not Applicable

Will you have transportation to/from the camp each day? (for in person camps)

Yes

Not Applicable

Clear selection

Why do you want to participate in QCaMP?

How are you hoping to connect your classes/curriculum to quantum science?

Submit

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