School Information
District Name*:
School Name*:
Street Address*:
City*:
State*:
MD
Zip*:
Teacher Information
Salutation:
Mr.
Mrs.
Miss.
Ms.
Dr.
First Name*:
Last Name*:
Number of Students*:
Send Materials In*:
Soonest Available
February 2024
March 2024
April 2024
May 2024
Grade You Teach*:
5
6
---- High School ----
9
10
11
12
Additional Participating Teachers at My School
Additional Teacher(s):
Salutation
First Name
Last Name
# of Student(s)
Email Address
Mr.
Mrs.
Ms.
Miss.
Dr.
How Can We Reach You?
Phone:
Phone Ext:
Alternate Phone:
Alternate Phone ext:
Fax Number:
Email Address*:
I’m going green! Please send my teacher materials digitally*
(*Digital teacher materials include: Teacher book, poster(s), teacher evaluation form,
incentive flier, state academic standards)
Comment