Teacher Website Feedback - Participation
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TEACHER FEEDBACK on a WEBSITE of EDUCATIONAL MATERIAL

Please complete the information below if you would like to be contacted to provide your FEEDBACK on a website created by a non-profit providing free educational material for teachers.

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1. How can we contact you? (Include as many options as possible):

How can we contact you? (Include as many options as possible): YOUR Name:
Email #1:
Email #2:
Phone #1:
Phone #2:
Fax:
Other (describe):

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2. List your LOCATION (City, State) and METROPOLITAN AREA (if you are in or near one).

List your LOCATION (City, State) and METROPOLITAN AREA (if you are in or near one).

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3. Describe your AVAILABILITY over SUMMER 2010 and FALL 2010
(For example, list weeks you ARE available, or indicate best times of day, etc.)

Describe your AVAILABILITY over SUMMER 2010 and FALL 2010 (For example, list weeks you ARE available, or indicate best times of day, etc.)

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4. BRIEFLY DESCRIBE your PAST teaching EXPERIENCE.
(For example, years teaching, recent training, certificates, etc.)

BRIEFLY DESCRIBE your PAST teaching EXPERIENCE. (For example, years teaching, recent training, certificates, etc.)

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5. BRIEFLY DESCRIBE your CURRENT or FUTURE teaching SITUATION.
(For example: grades, subjects, schools, location; whether an aide or substitute, etc.)

BRIEFLY DESCRIBE your CURRENT or FUTURE teaching SITUATION. (For example: grades, subjects, schools, location; whether an aide or substitute, etc.)

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6. BRIEFLY DESCRIBE - CURRICULUMS you are familiar with.
(Indicate how/why are you are familiar, such as recently taught, certified, etc.)

BRIEFLY DESCRIBE - CURRICULUMS you are familiar with. (Indicate how/why are you are familiar, such as recently taught, certified, etc.)

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7. GIFT CARD PREFERENCE - List ONE or MORE. Be specific.
(What KIND of gift card would you prefer?
Examples: Amazon, Target, Movie, food/beverage store, etc.)

GIFT CARD PREFERENCE - List ONE or MORE. Be specific. (What KIND of gift card would you prefer? Examples: Amazon, Target, Movie, food/beverage store, etc.)

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8. YOUR Mailing Address - for sending you the GIFT CARD.
(IF you are chosen to participate, where should we send your gift card? Please include zip code)

YOUR Mailing Address - for sending you the GIFT CARD. (IF you are chosen to participate, where should we send your gift card? Please include zip code)

~~~~~~~~~~~~~ THANK YOU ~~~~~~~~~~~~~~~

We will contact you over the summer to discuss participation.
Feel free to forward this invitation to OTHER TEACHERS.

-- YOUR INFORMATION will ONLY be used to SCHEDULE FEEDBACK SESSIONS (and not provided to any third party, used for marketing, or shared with anyone other than the people above and the non-profit organization for research purposes only) --

Teacher Website Feedback - ParticipationExit this survey

1. Default Section

*1. How can we contact you? (Include as many options as possible):

*2. List your LOCATION (City, State) and METROPOLITAN AREA (if you are in or near one).

*3. Describe your AVAILABILITY over SUMMER 2010 and FALL 2010(For example, list weeks you ARE available, or indicate best times of day, etc.)

*4. BRIEFLY DESCRIBE your PAST teaching EXPERIENCE.(For example, years teaching, recent training, certificates, etc.)

*5. BRIEFLY DESCRIBE your CURRENT or FUTURE teaching SITUATION.(For example: grades, subjects, schools, location; whether an aide or substitute, etc.)

*6. BRIEFLY DESCRIBE - CURRICULUMS you are familiar with.(Indicate how/why are you are familiar, such as recently taught, certified, etc.)

*7. GIFT CARD PREFERENCE - List ONE or MORE. Be specific.(What KIND of gift card would you prefer? Examples: Amazon, Target, Movie, food/beverage store, etc.)

*8. YOUR Mailing Address - for sending you the GIFT CARD.(IF you are chosen to participate, where should we send your gift card? Please include zip code)