* 1. First Name

* 2. Last Name

* 3. District where your school is located (use two digits, for example District 4 will be 04)

* 4. Borough

* 5. School Number (3-digits number) - DBN

* 6. School Name

* 7. Title/Role/Position

* 8. Email Address

* 9. Indicate the type of Bilingual Program in your school

* 10. If your school has a Bilingual Program, please indicate language.

* 11. Are you currently a DOE employee?

* 12. Place on email?

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