Participant Profile

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Participant Profile

As a publicly-funded organization, we are required to collect information on both the programs we offer and the people who attend those programs. In addition, we collect data in order to continually improve our service to California schools, teachers, and students through research, classroom practice and ongoing curriculum development. CSMP will not sell your data to any outside vendor. Thank you for taking the time to provide your information below.

First name *

Middle Name (Optional)

Last name *

Suffix (Optional)

Select the number that corresponds to your gender identity

1. Female

2. Male

3. Another gender

9. Decline to state

1 Female

2 Male

3 Another gender

9 Decline to state

Batalkan pilihan

Select the ethnicity descriptor that you feel best describes you. Choose 1, 0, or 9

1. Hispanic or Latino (A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture)

0. Not Hispanic or Latino

9. Prefer not to say

1 Hispanic or Latino

0 Not Hispanic or Latino

9 Prefer not to say

Select the number that best describes your identity and background. Each number corresponds to a specific group/identity. Select from 1-7 or 9

1. African American or Black (A person having origins in any of the black racial groups of Africa.)

2. American Indian or Alaska Native (A person having origins in any of the original peoples of North and South America, including Central America, and who maintains tribal affiliation or community attachment)

3. Asian (A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.)

4. Native Hawaiian or Other Pacific Islander (A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.)

5. White/Southwest Asian and North African (A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.)

6. Two or more

7 Other (not listed)

9. Prefer not to state

1 African American or Black

2 American Indian or Alaska

3 Asian

4 Native Hawaiian or Other Pacific Islander

5 White/Southwest Asian and North African

6 Two or more

7 Other (not listed)

9 Prefer not to state

Select the number which indicates the total number of years you have taught as a credentialed TK-12 teacher. Select the number 1-5 or 9 which accurately describes your years of experience.

1. 0-5 years

2. 6-10 years

3. 11-15 years

4. 16-20 years

5. 21 or more years

9. Prefer not to state

1 0-5 years

2 6-10 years

3 11-15 years

4. 16-20 years

5. 21 or more years

9. Prefer not to state

Primary email *

Alternate email (optional)

Home zip code *

School name *

Select the number that corresponds with your current role in education. Select from the 1-9.

1. Teacher/TOSAs

2. Counselor/County Office of Education Staff/School Staff

3. School/District Administrator

4. Pre-service Teacher (e.g., a student in a teacher-education program)

5. University Administrator/Faculty

6. Community Member

7. Parents

8. Other

9. Prefer not to say

1. Teacher/TOSA

2. Counselor/County Office of Education Staff/School Staff

3. School/District Administrator

4. Pre-Service Teacher

5. University Administrator/Faculty

6. Community Member

7. Par

8. Other

9. Prefer not to say

Select the number the corresponds with the grade span you teach currently. *

1. TK-2

2. 3-5

3. 6-8

4. 9-12

5. Other

9. Prefer not to state

Phone number

I am planning to attend the SECONDARY workshop: June 19 and June 20. *

I will attend the SECONDARY workshop (June 19-20, 2024)

I am not attending

Method of payment *

I will be paying with a personal credit card

Please invoice my district

I will pay using a different method, contact me.

I am a UC Davis School of Education student

If you would like to purchase Building Thinking Classrooms books, please click the link.

**Use code: RAVEN25 for 25% off and free shipping**

Thank you for completing your registration. We look forward to seeing you soon. We will contact you shortly regarding how to pay for your registration. Please look for an email from our offices. Payment options are credit card, check, or school purchase order.

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