A few questions, if you don't mind. STEM Pre-Academy Information Form Name * Name First First Last Last Email * Phone My School or Organization * Are you joining us for an event today? Yes, I am! No Which event? Are you a K-16 classroom teacher? * Yes! No Classroom Teacher Which grades do you teach? * K-2 3-5 6-8 9-12 College OtherOther Please select all that apply. Subject / Courses Taught * Number of Students * Other School Roles Not a Classroom Teacher What do you do? Non-classroom teacher School administrator State or complex area staff Non-profit staff Researcher Public / Private Industry OtherOther Please select all that apply. Where do you work? * Kaua‘i Leeward O‘ahu Central O‘ahu Honolulu Windward O‘ahu Maui, Moloka‘i, or Lana‘i Hawai‘i Island OtherOther Please select all that apply. How did you hear about STEM Pre-Academy? * This is my first time hearing of you! Currently on the mailing list Attended previous workshops/events Stopped by your table at a conference/event Invited to a meeting Searched the web Referred by a colleague (Who?) / Other (Please explain.)Referred by a colleague (Who?) / Other (Please explain.) Please select all that apply. May we add you to our friendly mailing list? Yes, please! No, thank you! If you have questions, comments, or other information you’d like to share with us, please do so here. Submit If you are human, leave this field blank. Δ
