Please note that you may sign up for only one of these grade levels at a time. We have created different lessons for different grade levels to ensure that all of our material is age appropriate. If you would like to sign up on behalf on two separate grade levels, please submit this form twice.
(Write N/A if you are signing up for an assembly).
Please list your earliest date preference to be no less than 10 days from the date you submit this form.
Date Format: MM slash DD slash YYYY
All sessions will run 45 minutes.
Date Format: MM slash DD slash YYYY
All sessions will run 45 minutes.
Date Format: MM slash DD slash YYYY
All sessions will run 45 minutes.
Date Format: MM slash DD slash YYYY
All sessions will run 45 minutes.
Session 2: Please list your earliest date preference to be no less than 10 days from the date you submit this form.
Date Format: MM slash DD slash YYYY
All sessions will run 45 minutes.
Date Format: MM slash DD slash YYYY
All sessions will run 45 minutes.
Date Format: MM slash DD slash YYYY
All sessions will run 45 minutes.
Date Format: MM slash DD slash YYYY
All sessions will run 45 minutes.
Session 3: Please list your earliest date preference to be no less than 10 days from the date you submit this form.
Date Format: MM slash DD slash YYYY
All sessions will run 45 minutes.
Date Format: MM slash DD slash YYYY
All sessions will run 45 minutes.
Date Format: MM slash DD slash YYYY
All sessions will run 45 minutes.
Date Format: MM slash DD slash YYYY
All sessions will run 45 minutes.
Session 4: Please list your earliest date preference to be no less than 10 days from the date you submit this form.
Date Format: MM slash DD slash YYYY
All sessions will run 45 minutes.
Date Format: MM slash DD slash YYYY
All sessions will run 45 minutes.
Date Format: MM slash DD slash YYYY
All sessions will run 45 minutes.
Date Format: MM slash DD slash YYYY
All sessions will run 45 minutes.
Demographic Questions
We collect demographic information as part of our evaluation efforts for the HEAT program. Any data shared with our evaluation partners will be shared without names. All fields are required to submit, so if you do not know the answers to any of the demographic questions, write “N/A.” If you do not have any students who match a description, write “0” instead of leaving the field blank.
How many students in each of the following grades will be in the HEAT group you’re signing up for?
List the percent of students who identify as each of these races at your school by relevant grade level. Data from 2020-2021 school year, please.
Example: You are signing up a class or group with 10th and 11th graders. Your school’s 10th grade is 50% African American, and your school’s 11th grade is 55% African American. Write something like “10th grade, 50%/ 11th grade, 55%” under the African American option.
List the percent of students who identify as each of these genders at your school by relevant grade level. Data from 2020-2021 school year, please.
Example: You are signing up a class or group with 10th and 11th graders. Your school’s 10th grade is 40% male, and your school’s 11th grade is 50% male. Write something like “10th grade, 40%/ 11th grade, 50%” under the male option.
This field is for validation purposes and should be left unchanged.