Commack High School Community Ambassador Program April 2017

Commack High School Community Ambassador Registration Form

The Commack School District welcomes you to register to visit Commack High School on April 4, 2017,, starting at 8:45am, for the second Community Ambassador Program of the 2016-2017 school year. This session will give you an inside look at the STEAM (Science, Technology, Engineering, Arts, and Math) program.

Please note that participation in this event cannot be guaranteed as a limited number of seats are available. We will do our best to allow each community member the opportunity to attend this high school visit, or others in the future. We apologize in advance if we cannot provide an opportunity in any session due to an overwhelming response.

Please complete this form to register. You will be contacted by school staff to confirm your participation.

Question Title

* 1. Please provide the following contact information so we can communicate with you about the event.

Name *

Address

City/Town

State/Province

ZIP/Postal Code

Email Address *

Phone Number *

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* 2. Please let us know your current status as a community member.

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* 3. If you have school-aged children, what grade(s) are your child(ren) currently enrolled? Check all that apply.

K-2

3-5

6-8

9-12

Question Title

* 1. Please provide the following contact information so we can communicate with you about the event.

Question Title

* 2. Please let us know your current status as a community member.

Question Title

* 3. If you have school-aged children, what grade(s) are your child(ren) currently enrolled? Check all that apply.

Question Title

* 4. Please let us know if you are currently a member of any community groups such as PTA, SEPTA, educator from another district, realtor, etc....