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FY23 Teacher Information Form
Please fill out this survey to better help us throughout the year with contact and other general information.
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* Indicates required question
First Name
*
Your answer
Last Name
*
Your answer
Age Range as of June 30, 2022
*
21-25
26-30
31-35
36-40
41-45
46-50
51-55
56-60
61+
School Name
*
Your answer
Your Cell Phone Number
*
Your answer
Area
*
1
2
Your School Email
*
Your answer
How many Extended Year Days does your contract include?
*
Your answer
Teaching Certificate Type
*
Provisional
T-4
T-5
T-6
T-7
How were you certified?
*
Traditional Ag Ed Teacher Preparation Program
Alternatively Certified
Number of years teaching Agriculture Education as of June 30, 2022
*
Your answer
School Street Address
*
Your answer
School City
*
Your answer
School Zip
*
Your answer
School System
*
Your answer
School Phone Number
*
Your answer
System CTAE Director
*
Your answer
System CTAE Director Email
*
Your answer
School CTAE Director if different from above
Your answer
School CTAE Director Email
Your answer
School Principal
*
Your answer
Principal Email
*
Your answer
List your State Senator(s)
*
Your answer
List your State Representative(s)
*
Your answer
Do you have an organized FFA Alumni Affiliate?
*
Yes
No
Alumni President or Best Contact Name
Your answer
Alumni President or Contact Email
Your answer
Have you received the Honorary State FFA Degree?
*
Yes
No
Have you received the Honorary American FFA Degree
*
Yes
No
Would you be interested in serving as a Proficiency Award judge on March 23, 2023?
*
Yes
No
Would you be interested in serving as a National Chapter judge on March 30th-31st, 2023?
*
Yes
No
Would you be interested in serving as an Agriscience Report judge on March 30th-31st, 2023?
*
Yes
No
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