Future Quest Island-Explorations: Interest Form

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We are seeking teachers in grades 3-5 including general education classrooms, special education classrooms, and after-school programs to participate in a 4-6 week research study beginning fall 2022. The study involves the implementation of a time-limited online curriculum supporting improved self-concept, social and emotional competence, and early college and career awareness for students with and without disabilities. All activities in the study would occur virtually. The program is free for participating schools.  Please complete the form below to express your interest in participating in this research study on the Future Quest Island-Explorations online curriculum.

Completion of this form in NO WAY commits you to participate in this study. It will only allow our research team to share further information with you about the curriculum and the study.

Email *

What is your role? *

Job Title: *

Name (first and last): *

School Email Address (must be provided) *

Do you work at an elementary school, after school program, or another type of educational program serving students in grades 3, 4, or 5? *

Yes

Which grade levels does your school or program serve? Select all that apply. *

3rd grade

4th grade

5th grade

after school program serving students in grades 3-5

other program serving students in grades 3-5

Other:

Required

Name of your school/program: *

Name of your school district: *

State in which your school/program is located: *

Do students in your school have a different teacher for core subjects such as ELA, math, science in grades 3-5? *

Yes, for all 3-5 grades

Yes, but only for 4th and 5th grades

Yes, but only for 5th grade

I'm not sure

N/A, I teach in an after-school or other extra-curricular program

Other:

Required

Which approach to teaching and learning will your school use this school-year? *

In-person

Online

Hybrid

Some students online, some students in-person at the same time

I'm not sure

Other:

Required

How did you hear about our program/study?

Conference Presentation

Facebook Post

Twitter

Colleague

ASCA

CEC

FableVision

State Organization

I'm not sure

Other:

Are there other teachers or administrators you feel might also be interested in this research study?

Yes

Maybe

Clear selection

If yes, please provide contact information.

A copy of your responses will be emailed to the address you provided.

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