Planning Form
Name
*
First Name
Last Name
Enter your email
*
example@example.com
School Name/ Number Ex: PS94Q
*
Cycle
*
Please Select
1
2
3
Multi
Summer
Select one:
*
In-School
After-School
Grade Level/ Age
*
Title of Residency
*
How many sessions total
*
Select all the dates sessions will be held. Please use the "Add Session" button to include ALL of your session dates. This form is not considered complete unless all sessions are listed.
*
Will there be a culminating event? (You will be asked to confirm this by week 6)
*
Yes
No
TBD
Enter the date of Culminating Event
 /
Month
 /
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Time of Culminating Event
Hour Minutes
AM
PM
AM/PM Option
Please enter the following information for your main school administrative contact. This can be a Principal, AP, Parent Coordinator, etc.
*
Do you have an additional school administrator whose information you need to add?
No
One more
Two more
Please enter the following information for your additional school administrative contact.
*
Please enter the following information for your additional school administrative contact.
*
How many classes will you be teaching?
*
Enter the following information for your first class (If this is an after-school residency, please provide the info for your main school administrative contact):
*
Enter the following information for your second class:
*
Enter the following information for your third class:
*
Enter the following information for your forth class:
*
Enter the following information for your fifth class:
*
Enter the following information for your sixth class:
*
Enter the following information for your seventh class:
*
Enter the following information for your eighth class:
*
Enter the following information for your ninth class:
*
Enter the following information for your tenth class:
*
Enter the following information for your eleventh class:
*
Enter the following information for your twelfth class:
*
Residency Notes & Safety Protocol:
*
Submit
Should be Empty: