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* 1. School name:

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* 2. School district:

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* 3. School phone:

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* 4. School fax:

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* 5. School address (physical):

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* 6. School address (mailing):
Please note that survey materials cannot be sent to P.O. Boxes.

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* 7. Estimated number of students participating:

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* 8. Number of students in largest participating classroom:

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* 9. Total number of participating classrooms:

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* 10. Primary contact person for survey administration:

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* 11. Secondary contact person for survey administration:

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* 12. School principal:

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* 13. Desired survey administration date:  
The survey is available for administration from Feb 24th - May 18th and will take approximately 45-60 minutes to complete.

Administration date (MM/DD/YYYY) must take place between 02/24/2020 and 05/18/2020 

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* 14. How would you like the survey to be administered?

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* 15. Please indicate which contact(s) should receive a copy of your school report containing results from the 2020 AYS.

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* 16. If you would like your school's name withheld as a participant from public requests about AYS, please check the box below.

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* 17. Is your school a Bureau of Indian Education (BIE) school?

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* 18. Who is filling out this form?

Submit the survey by clicking the 'Submit' button below.

You can also return your completed survey to:

Email: AYS@azcjc.gov 
Fax: 602-364-1175

Or mail a physical copy to the following address: 

Arizona Criminal Justice Commission
Statistical Analysis Center
1110 W Washington, Suite 230
Phoenix, AZ 85007
Phone: 602-364-1157
 
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