Visual Learners in the Digital Age: LAUSD Registration Form
Title *
First Name *
Your answer
Last Name *
Your answer
What is your Employee Number? *
Your answer
First Time Student? *
If you are not a LAUSD teacher, you are filling out the wrong form.
Primary Email Address *
Please provide the email address you primarily use outside of school.
Your answer
School Email Address *
Your answer
What email address will you be using for this class? You need to provide either a Gmail address or a school email address (only if your school uses Google Apps for Education) in order to join the class. This may be the same as one of the addresses you provided above. *
This can either be a gmail address or a Google Apps for Education address.
Your answer
Does your school use Google Apps for Education? *
Street *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Cell Phone *
Your answer
What is the name of the School in which you are currently teaching? *
Your answer
Subject(s) Taught *
Your answer
Grade(s) Taught *
Your answer
What semester are you taking the course(s)? *
PROMOTIONAL CODE: If you have a promotional code for a discounted course, enter it here.
Please be sure to also enter the name of the person you recommended on the next question.
Your answer
First Time Students: Please enter the name of the person who first introduced you to Ed Technology Specialists
Enter the First and Last Name.
Your answer
After hitting "Submit", please be sure to pay your tuition. In addition, you will immediately be sent an email (to your primary email account) with further instructions to start the class. Please check your inbox or spam box right after you hit "submit" to receive the directions. THANK YOU!
Submit
Never submit passwords through Google Forms.
This form was created inside of Mallack Walsh Edtech Services. Report Abuse - Terms of Service - Additional Terms