TEACH196 District Graduates Exploring Education as a Career Contact List
The district is very proud of all of its graduates and is particularly interested in developing a contact list for district students who are interested in pursuing a career in education as part of the TEACH196 program.  The district is very interested in hiring its former graduates, and this list is a means by which the district can keep in contact.  This contact list may be used by the district to disseminate information such as summer employment opportunities, district hiring resources, hiring deadlines, and other employment information.  Providing the information requested in this form is completely voluntary and is for school district use only for the purposes described above. The consequence of not providing the requested information is simply that the Teach196 program will not be able to reach out to you with information about employment opportunities. The information you provide will be shared with staff members within District 196 who are responsible for employee hiring or administering the TEACH196 program. It may also be shared as required by law.  If you have any questions about this form or the contact list, please contact the Director of Human Resources, Shelly Monson, at Shelly.Monson@district196.org.  
Name (last, first) *
College/University Currently Attending *
College Major(s) *
Area of focus (e.g., choral music, social studies, chemistry, special ed, school psychologist, etc.) *
Anticipated Teacher Licensing Level (e.g., Birth-3, K-12, K-6, 6-12, etc.) *
Interested in teaching at what level (early childhood, elementary, middle, high school)? *
Preferred Contact E-mail *
Preferred Phone Contact Number (Optional)
High School Graduation Year (YYYY format - e.g.,  2018) *
Anticipated College Graduation Year (YYYY format - e.g.,  2021) *
Anticipated College Graduation Semester
High School Attended *
Middle School Attended (Optional)
Elementary School Attended (Optional)
Interest in periodic e-mail contact by a ISD196 teacher to serve as a resource for answering questions you may have about teaching in the district? (Y/N) You may choose not to participate in the future. *
What district class/program(s), if any, played a role in your decision to pursue a career in education? (Optional - you may check more than one)
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