Connecticut's Kid Governor® 2022-23 - Class Registration Form

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Welcome to the Connecticut's Kid Governor® 2022-23 program!

Please complete the following form - once for each participating class - to officially register your 5th grade class to participate in Connecticut's Kid Governor® 2022-23. You will receive a confirmation email in the coming days verifying your registration and with important information for this year's program. All classes must register no later than Friday, November 4, 2022 in order to vote in the Statewide Election.

Registered teachers will receive regular updates and voting instructions via email. If you do not receive email updates after registering, please contact us so we can verify your contact information.

If you have any questions, please contact Nichole Pitruzzello, Connecticut's Kid Governor® State Coordinator, at Nichole.Pitruzzello@CT.KidGovernor.org or visit CT.KidGovernor.org. Our team is looking forward to an exciting election season!

Kid Governor® is an award-winning statewide civics program created by The Connecticut Democracy Center at Connecticut's Old State House.

Teacher Title: *

Dr.

Mr.

Mrs.

Ms.

Teacher First Name: *

Teacher Last Name: *

Teacher Email: *

Please enter a valid SCHOOL email address. CT's Kid Governor will not share your information.

Teacher Phone Number (school): *

Please enter a valid SCHOOL phone number. CT's Kid Governor will not share your information.

Teacher Phone Number (cell):

Please enter a valid CELL phone number. Your cell phone number will only be used as a backup to your school number, if we need to contact you with an urgent question or information. CT's Kid Governor will not share your information.

School: *

Town/City: *

My class will be participating in Connecticut's Kid Governor® 2022-23 by: *

Nominating a candidate for Connecticut's Kid Governor and voting in the Statewide Election (Note: one candidate per school; an in-school primary is recommended for schools with multiple participating 5th grade classes. Toolkit of in-class lessons will be emailed to you)

Voting in the Statewide Election (Toolkit of in-class lessons will be emailed to you)

Number of students in class: *

The Connecticut's Kid Governor® team is planning the third annual statewide Election Rally Bus Tour for November 2022! During the Statewide Election, we will visit a handful of participating schools to get students excited for voting in the election. See photos from our 2021 tour here: https://bit.ly/3z1xzd1. Check this box to be considered for a bus tour stop this November!

By checking this box, I confirm that I am a 5th grade teacher (or the person leading the Kid Governor program in my school) in Connecticut and that my class will participate in the Connecticut's Kid Governor® 2022-23 program. I agree to follow the guidelines of the program and the rules of using the program materials, and consent to receiving regular program update emails from Connecticut's Kid Governor®/The Connecticut Democracy Center.

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