JA EduSpark Summer Teacher Externship 2021

Wednesday, June 30th

Ed Martin Automotive: 9:00am-10:30am
Lunch Break
Paul Mitchell: 11:30am-1:00pm
Networking with Peers: 1:00pm-1:30pm

Zoom Virtual Event

Name*

First Name

Last Name

Work Email*

Personal Email

Your Cell Phone Number*

We ask for you cell phone number in case we need to contact you day-of.

Mailing Address (to send your event materials) *please do not put school address if closed for the summer**

Address Line 1

Address Line 2

City

State

ZIP Code

I would like to attend the following: (please select only one!)*

Ed Martin Automotive Industry Tour ONLY (9:00am-10:30am) Paul Mitchell Cosmetology School Industry Tour ONLY (11:30am-1:00pm) Both Industry Tours for Full Teacher Externship (9:00am-1:30pm)

You will receive 1.5 Professional Growth Points for each industry tour you attend. We encourage you to attend the full Teacher Externship if you are able!

Select the school district you work/teach for.*

Please select one.

Indicate "other."

What school do you work/teach for?*

If district level or not school staff please type N/A.

What is your role?*

Please select one.

Indicate "other."

What grade do you teach?*

If district level or not school staff please type N/A.

What subject do you teach?*

If district level or not school staff please type N/A.