Document your GeoMentor Experience!
Thank you for your participation as a GeoMentor and your role in improving GIS and geography education in the US.  Please complete the short form below telling us the WHO / WHERE / WHEN / WHAT about your mentoring engagement to help us track program progress and celebrate your efforts!  Alternatively you can email program staff at geomentors@aag.org.  If you have completed multiple engagements, please complete the form for each activity.  We'll email you your GeoMentors Certificate to document your service.  You can earn one certificate per year per school/group worked with.

Collected information will only be accessible to and used by AAG and Esri GeoMentoring program staff and will not be further distributed unless you indicate your permission to do so in question #1 below.  Please contact program staff at geomentors@aag.org at any time with questions or concerns.
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Data Use Permission
1.  May we use your provided GeoMentoring experience information for public program mapping, marketing, and/or reporting? *
Contact Information
Your Name: *
Your Email Address: *
WHO did you volunteer with as a GeoMentor?
Please note what school and/or educational group you collaborated with for this GeoMentoring engagement.
Name of School, School District or Group/Club: *
Grade Level or Age Range of Students you worked with or of the students your Educator Collaborator works with (if applicable):
Classroom Subject or Topic of interest (if applicable):
Estimate of the number of people reached:
(e.g. Number of students in the class or group, Number of workshop attendees)
WHERE did your GeoMentoring activities take place?
City: *
State: *
WHEN did this GeoMentoring activity or collaboration take place?
Please provide the date or date range of your GeoMentoring experience.  (e.g. month/date/year of a presentation; month/year of collaboration/communication with a teacher; or months/years range of ongoing collaboration) *
WHAT did you do as a GeoMentor?
Please describe how you assisted educators and/or worked with students (e.g. researched and provided topic or data resources, helped educator set up and use ArcGIS Online, gave a careers talk to students, developed a new exercise related to topic of interest). *
Please provide links to any produced content (e.g. lesson plans) or documentation of the project (e.g. blog posts, social media posts, school reporting, photos, etc.) if available.
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