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* 1. Name

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* 2. Email address

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* 3. School or affiliation, City, State

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* 4. Please summarize your submission for the "Innovation with Impact" award.

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* 5. What is the age group for this program?

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* 6. Provide details of how the program works and the role of the students, including the way in which it is a real-world experience. 

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* 7. Why do you consider this program going beyond the standard lesson format, into a "Innovation with Impact" program?

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* 8. How is the program being replicated within your school community? 

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* 9. Describe the positive impact this program had on the students, environment, and/or community.

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* 10. How do you see other school communities adopting this program?

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* 11. Please upload more information about this program, including photos. 

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* 12. You may upload your school's website here, if the program is featured on it. 

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* 13. Do we have permission to highlight your program on our website?

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