TEACH Columbia Gorge Grow Your Own Interest Form

Thank you for your interest in the GYO program!

Please complete the information below and then schedule a brief introduction call with the GYO Program Coordinator (link to schedule at end of form). If you are unsure on the response to a question, that is more than okay, just answer based on what you do know. The GYO Program Coordinator can coach you through the application- just sent an email, call or text.

If you would prefer to complete these questions via phone with the GYO Program Coordinator, click here to schedule a 30minute phone/zoom call.

All information shared will be viewed by the GYO review committee only and not shared elsewhere without your written consent.

Please reach out with any questions!

mschorr@cgesd.k12.or.us OR 541.993.7935

Background Info & Demographics

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* 1. First name

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* 2. Last name

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* 3. Pronouns

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* 4. Email address

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* 5. Confirm email address

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* 6. Phone number

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* 7. Gender identity

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* 8. Sexual orientation

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* 9. Age

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* 10. Race/Ethnicity (select all that apply)

Asian or Asian American

Black or African American

Latino/a/e/x or Hispanic

Native American or Alaska Native

Native Hawaiian or Pacific Islander

White or Caucasian

Prefer not to answer

Race/Ethnicity not listed above, please write in comment box below:

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* 11. Tribal affiliation

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* 12. Language of origin

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* 13. What languages do you speak and what is your fluency?

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* 14. What language do you prefer to communicate in?

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* 15. Do you have any dependents?

Yes

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* 16. What county do you live in?

Sherman

Wheeler

Hood River

Wasco

Gilliam

Other (please specify)

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* 17. How long have you been an Oregon resident?

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* 18. What is your zipcode?

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* 19. What is the highest level of education you have completed?

Some highschool coursework

Highschool or GED

Some college coursework completed

Associate's degree

Bachelor's degree

Master's degree

Technical or occupational certificate

Other (please specify)

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* 20. Please list degree(s), licensure(s), and/or endorsement(s) you have completed below

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* 21. Are you and/or would you be a first generation college student (A first-generation college student is a student whose parents did not complete a four-year degree)?

Yes

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* 22. Please mark which option below best describes where you are currently:

I am currently applying and/or I am going to be applying to a college/university within the next 3 months

I am currently enrolled at a college/university

I am interested in getting my teaching licensure and I am in the information collecting phase (i.e. not yet ready to apply, but would like to learn more)

Other (please specify)

10% of survey complete.