STEM Pre-Academy Participation Form STEM Pre-Academy Participation Form Aloha! Thank you for your interest in the STEM Pre-Academy program! To join the program, please fill out the form below. If you have questions, please add them to the final question of the form, or contact us at stempre@hawaii.edu. Mahalo! Basic Information Are you a new or returning participant? * New Participant (I am a Hawai‘i public/charter middle school teacher - 6th, 7th, and 8th grades) Returning Participant (Please update my information.) New Affiliate (I am NOT a Hawai‘i public/charter middle school teacher.) Returning Affiliate (Please update my information.) Note that participation in our program is completely voluntary. How would you define your participation? * I am a public middle school teacher. I am affiliated with the STEM Pre-Academy Digital Media program. I am affiliated with the C-MORE Science Kit program. I am affiliated with the HiSCI/JABSOM program. I am affiliated with the Castle Complex K-16 Engineering Pipeline Project OtherOther Please choose all that apply. How did you learn about us? * Name * Name First First Last Last Primary Email Address * Primary Phone Number * Secondary Email Address Secondary Phone Number School / Organization * School / Organization Phone Number Areas of Interest * For Teachers School Principal / Administrator School District Grade Levels Taught K-5 (Elementary) K-6 (Elementary, but I teach 6th grade) 6 (Intermediate / Middle) 7 (Intermediate / Middle) 8 (Intermediate / Middle) 9-12 (High School) If you are a teacher, what grade levels will you be teaching this year? Please, check all that apply. Subjects Taught Other Current School Responsibilities Number of Years Teaching at Current School Total Number of Years Teaching College or University Attended plus1 Add minus1 Remove Major, Degree Obtained, and Year plus1 Add minus1 Remove Credentials and Certifications plus1 Add minus1 Remove Other Information or Questions If you are human, leave this field blank. Submit
