High School Educator Notice *

I understand that in order to be considered for the Chapter President position, I must be a currently certified teacher at the high school level.

Yes, I am a teacher

Background Check Notice *

I understand that In order to be considered for the Chapter President position, I must participate in a background check.

I understand

Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Gender *

To which gender identify do you most identify?

Female

Male

Transgender Female

Transgender Male

Gender Non-Conforming

Other

Date of Birth *

MM

DD

YYYY

How Did You Hear About Us?

Online (social media, news coverage, etc.)

Current Chapter President

STARTedUP Programming (Chapter, Hackathon, Innovate WithIN Competition)

Student Request

Don Wettrick speaking engagement

Other

How long have you been in the field of education? *

1-5 years

6-10 years

11+ years

Which of the following classes or afterschool programs have you taught or led?

Business

Entrepreneurship

STEAM (science, technology, engineering, art, math)

Other

If you are currently volunteering, how many hours per month are your current volunteer commitments? *

1-5 hours/month

6-10 hours/month

11+ hours/month

I am not currently volunteering anywhere

Availability *

The role of Chapter President involves about 8 hours of volunteer work per month (approximately 2 hours per week). Do your current commitments allow for this time commitment?

Yes

No