*First Name
*Last Name
*Rank/Position
*Race/Ethnicity	White African American Hispanic/Latino Asian Native American/Indigenous Peoples Middle Eastern Pacific Islander South Asian Biracial/Multiracial Other White African American Hispanic/Latino Asian Native American/Indigenous Peoples Middle Eastern Pacific Islander South Asian Biracial/Multiracial Other
*Gender	--None--Male Female Prefer not to say
*Agency/Organization
*Agency City
*Agency County
*Agency State	--None--Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia 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 Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
*Email
*Cell Phone
*Date Trained by L.E.A.D.	[ 11/20/2024 ]
*How many cycles of the 10-week program have you taught
*When do you expect to begin teaching in the 2024-25 school year	[ 11/20/2024 ]
*What Grade(s) will you be teaching in 2024-25	Kindergarten 1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th Kindergarten 1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th
*How many total students will you teach in all grades in the 2024-25 school year