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River City Teacher Inquiry Form

Teacher Inquiry Form
Thank you for your interest in the River City Project. In order to create your account we ask that you please fill out this information form. We will use the information you provide to set up your accounts. Your information will be used internally by River City personnel only and will never be distributed to any outside lists. Fields with (*) are required.
First Name*:    
Last Name*:    
School Name*:    
School Address*:    
School City*:    
School State/Province*:    
School Zip*:    
Email*:    
Computer Operating System*:    
   
Approximately when do you plan to implement River City?    
Month: Year:    
Approximately how many of your classes will likely participate in the River City Project the first time you implement River City with your students?    
Approximately how many students will this involve?    
River City offers you the option of a student pre-survey. A comparison of pre- and post- experience knowledge can assist you to gauge the value of the the students experience. The pre-survey contains 27 questions many of which are multiple choice. This may take a full class period. If the pre-survey option is chosen students will be required to complete and submit the entire pre-survey prior to entering River City. You will receive their answers via email. If you chose not to have the pre-survey activated students will go straight to River City.

The following information about you will be analyzed only in the aggregate with other teachers for research purposes. This information is not required but is appreciated:
Age:    
Gender:    
What grade levels are you teaching this year? (Check all that apply)
Grade 5    
Grade 6    
Grade 7    
Grade 8    
Grade 9    
Grade 10    
Grade 11    
Grade 12    
Academic Environment:    
School Geography:    
Teaching Schedule:    
Average Class Length (minutes):    
Average Students per Class:    
Primary Subject Area (this year):    

What is the name and contact email of your technology coordinator, or person responsible for installing technology on your school computers?
Tech's Title:    
Tech's First Name:    
Tech's Last Name:    
Tech's Email:    
     

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