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* 1. First and Last Name

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* 2. Email Address

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* 3. Phone Number

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* 4. Name of School

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* 5. Classification for 2024-2025 School Year

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* 6. In what health field are you interested?

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* 7. A component of the Building Health Teams program is interviewing a health professional/provider. Please list in order of preference, 3 health professionals/providers you would like to learn more about. Do not include the health field from question #6.

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* 8. Why are you interested in participating in this program? (up to 250 words)

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* 9. Discuss a time you've been on a team. Would you consider that team effective, dysfunctional, or somewhere in between? Explain the characteristics that made or would have made that team effective. (100-250 words)

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