Oregon EdTech Professional Development Cadre Registration for 2019-20
This registration should be completed by the person attending Cadre in 2019-20.
* Required
First Name
*
Your answer
Last Name
*
Your answer
Your email address
*
Your answer
Work Phone Number
Your answer
Cell Phone Number
Your answer
Organization or District Name
*
Your answer
To what email address should we send an invoice for your registration?
*
Your answer
Food Restrictions
*
Gluten Free
Vegetarian
Vegan
Low Sodium
Dairy Free
Medically Restricted
Other:
Required
Supervisor
*
Your answer
Supervisor Email
*
Your answer
Supervisor Mailing Address
*
Your answer
Your Job Title
*
Your answer
At what level do you work?
*
Classroom(s)
District
ESD
State
Post Secondary
Other:
Required
Your Roles
*
(select all that apply)
Teacher
Administrator
Instructional Support
Coach
Technical
Curriculum Leadership
Tech Committee
Business/Industry
Other:
Required
To whom do you provide professional learning?
*
(select all that apply)
Teachers
Administrators
Coaches
Technical Staff
Classified Staff
Mixed Groups
Parents
Community
Other:
Required
At what levels do you provide professional learning?
*
1:1
Small Groups
School
Multiple Schools
District-wide
Regional
ESD Service Area
State-wide
National
International
Required
How many times in an average month do you provide PD?
*
Choose
5 or more times a month
3-4 times a month
Twice a month
Once a month
Less than once a month
Never
What role do you play in developing your school or district technology plan?
*
Choose
I lead the team
I have a place on the team
I’m an advocate
I do this alone
Nothing
Number of years in Cadre?
*
Choose
0 - first time applicant
1-2 years
3-4 years
5-6 years
7-8 years
9 or more years
Why are you interested in Cadre?
*
Your answer
What is the most important topic about which you’d like to learn this year?
*
Your answer
How will you share and/or implement the lessons learned at Cadre?
*
Your answer
Submit
Page 1 of 1
Never submit passwords through Google Forms.
This form was created inside of Oregon Department of Education.
Report Abuse
Forms