Public: New Teacher Registration Please complete the profile form below. This information will auto-fill future forms for programs to make the application process faster and more consistent! Personal Information Honorific Ms.Mrs.Mr.Dr.Other Honorific (Optional) Name * Name First Name First Name Last Name Last Name Password * eye_icon eye_slash_icon cancel1 check1 Eight characters minimum cancel1 check1 One lowercase letter cancel1 check1 One uppercase letter cancel1 check1 One number cancel1 check1 One special character Confirm Password * eye_icon eye_slash_icon (Confirm Password) Teacher Status * I am currently a teacherI am a retired teacherI am a future educator NOTE: Future Educator status is for those currently or planning to enroll in college to work toward a career in education. Selecting this option will limit your access to programs to only include the Future Educator Scholarship. Personal Phone * Personal Email * Please do NOT use a school/district email here. This will become your username. School/District Email * Due to filtering, this will only be used if we can't reach you at your personal email. Personal Address * Please do NOT use a school/district address here. This will be used to ship any prizes to. Personal Address Line 2 Personal City * Personal State * AZAKALARCACOCTDCDEFLGAHIIAIDILINKSKYLAMAMDMEMIMNMOMSMTNCNDNENHNJNMNVNYOHOKORPARISCSDTNTXUTVAVTWAWIWVWY Personal Zip * School/District Information NOTE: Please provide the information for the last school you at which you were a teacher. School, Center, or Facility Name * School Address * School Address Line 2 School City * City School State * AZAKALARCACOCTDCDEFLGAHIIAIDILINKSKYLAMAMDMEMIMNMOMSMTNCNDNENHNJNMNVNYOHOKORPARISCSDTNTXUTVAVTWAWIWVWY State School Zip * Zip Code School Location * Pima CountySanta Cruz CountyCochise County Type of School * PublicPrivateCharterOther Type of School Is your school part of a District? * YesNo District Name * Ajo USDAltar Valley ESDAmphitheater USDApache ESDBaboquivari USDBenson USDBisbee USDBowie USDCatalina Foothills USDCochise ESDCochise Technology DistrictContinental ESDDouglas USDElfrida ESDEmpire ESDFlowing Wells USDFt. Huachuca Accomodation SDMarana USDNaco ESDNogales USDPatagonia ESDPatagonia Union HSDPima Accommodation DistrictPima County JTEDRedington ESDSahuarita USDSan Fernando ESDSan Simon USDSanta Cruz ESDSanta Cruz Valley USDSierra Vista Public SchoolsSonoita ESDSt. David USDSunnyside USDTanque Verde USDTombstone USDTucson USDVail USDWillcox USD Teaching Information NOTE: Please provide the historical information for your teaching career. What year did you become a teacher? * Current Number of Students * (Approximate) Lifetime Number of Students * 1 - 100101 - 250251 - 500501 - 750750 - 1,0001,001 - 1,5001,501 - 2,0002,001 - 3,0003,001 - 4,0004,001 - 5,0005,001 - 6,0006,001 - 7,0007,001+ (Approximate) What year did you retire? * Grade(s) You Teach/Taught * PreK 1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th Subject(s) You Teach/Taught * Teaching Certificate Drop a file here or click to upload Choose File Maximum file size: 516MB Date Teaching Certificate Expires * Demographics Information This information is for grant reporting only and does not impact the selection process for any programs. If you do not wish to disclose this information, you may choose “I prefer not to say” on any or all items below. Gender Identity * MaleFemaleNon-BinaryI prefer not to sayOther Gender Identity Hispanic/Latino Origin * Hispanic or LatinoNon-Hispanic or Non-LatinoI prefer not to say Race Designation(s) * Asian Black or African American Native American Native Hawaiian or Other Pacific Islander White Multi-Racial I prefer not to say Other Race(s)Other Race(s) Submit If you are human, leave this field blank.
