2017 MOOC Interest Form Thank you for your interest in learning more about the Roots & Shoots Online Course, Growing Compassionate Leaders: Empowering Youth Through Service in EducationWith the information you provide to us, we will send you updates and notify you when registration opens! * 1. Please provide the following: First Name Last Name Email Address Phone Number City, State * 2. How did you find out about the Roots & Shoots Online Course? Conference or outreach event (please specify event name below) Organization (please specify organization name below) Past/current participant (please specify participant name below) Social media (please specify where) Other (please specify below) (please specify) * 3. When would be your preferred time to take the online course? You may select multiple answers. (Dates are hypothetical) January July October Done