SENSE IT Workshops Registration Survey

1. Please select the workshop(s) you plan to attend:

*

2. Please provide your name, home address and contact information:

Please provide your name, home address and contact information: Name:
Home Address:
Home Address 2:
City/Town:
State:
ZIP:
Email Address:
Phone Number:

*

3. Please provide the name of your school and school address:

Please provide the name of your school and school address: School Name:
School Address:
School Address 2:
City/Town:
State:
ZIP:
Country:
School Phone Number:

4. Which grade levels and courses do you teach?

Which grade levels and courses do you teach?

5. In which course(s) do you plan to implement the SENSE IT sensors?

In which course(s) do you plan to implement the SENSE IT sensors?

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