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e3 Smart – Registration
e3 Smart - Registration
You are registering for the following program
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e3 smart elementary
e3 smart secondary
Are you new to the e3 Smart program OR have you participated in the e3 Smart program within the last five years?
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New Teacher
Returning Teacher
I plan to attend the following professional development training for the 2023-2024 school year.
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e3 Smart Virtual Training
I am interested in an in person training (time and location TBD)
Training videos will be uploaded to OEP website by July- after viewing the training video you will be asked to confirm your student kit number in a Post PD Questionnaire
Which option matches or closely resembles your teaching assignment for the 2023-2024 school year?
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3 Science
4 Science
5 Science
6 Science
7 Science
8 Science
9 Science
Environmental Science
Other
Please specify "other"
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Are you interested in learning more about graduate credit through this program?
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Yes
No
Graduate credit is at your expense and is facilitated through our Canvas platform.
How would you rate your confidence in teaching your grade level's energy content standards?
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Very confident
Confident
Neutral
Somewhat confident
Not at all confident
How would you rate your confidence in applying STEM concepts to your energy lessons?
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Very Confident
Confident
Neutral
Somewhat Confident
Not at all Confident
Your Name
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First
Last
School
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School District
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How would you describe your school district?
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Urban
Rural
Suburban
School Address
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Street Address
County
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
School Phone
School Email
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Estimated number of students expected to participate?
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Your final number will be confirmed when school starts. Please estimate as best you can to help with OEP planning. **Minimum of 25 kits is required to participate**
Percentage of students on free/reduced lunch?
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0-49%
50-74%
75-100%
Signature
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First
Last
I agree to utilize the e3 Smart curriculum in my classroom and submit program evaluation data by April 15, 2024. I authorize OEP and program partners to use photographs or videos of me or quotes by me for educational or promotional purposes in any type of media, including its website. The photographs, videos or quotes may not be used for profit without my express permission. I understand I will not be paid or rewarded for providing this authorization. By typing your name above, you agree to these requirements.
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