50% of survey complete.

* 1. First Name

* 2. Last Name

* 3. Exact birth date, including day, month and year.

* 4. Gender (for demographic purposes)

* 5. Ethnicity (for demographic purposes)

* 6. Email Address

* 7. Phone Number

* 8. Street Address

* 9. City and State

* 10. Zip Code

* 11. At which Supplementary School(s) do you expect to teach during the 2013-2014 school year? Please select all that apply.

* 12. Please list what topics you will be teaching in the 2013-2014 school year.

* 13. Please indicate what grades/ages you will be teaching in the 2013-2014 school year.

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