Teacher Input Form Web Site School District (if private, put school name here; if home school, put your name here) * District Phone (if private school, put school number here; if home school, put your number here) * Name of School (if private school, put name here; if home school, indicate that) * School Phone (if home school, put your number here) * School Mailing Address (if home school, put your address here) * School City * School State * Select a State/ProvinceAlabamaAlaskaAlbertaAmerican SamoaArizonaArkansasArmed Forces AmericasArmed Forces EuropeArmed Forces PacificBritish ColumbiaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineManitobaMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew BrunswickNew HampshireNew JerseyNew MexicoNew YorkNewfoundland and LabradorNorth CarolinaNorth DakotaNorthern Mariana IslandsNorthwest TerritoriesNova ScotiaNunavutOhioOklahomaOntarioOregonPennsylvaniaPrince Edward IslandPuerto RicoQuebecRhode IslandSaskatchewanSouth CarolinaSouth DakotaTennesseeTexasUnited States Minor Outlying IslandsUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyomingYukon Territory School Zip * Teacher Name * Teacher Email * Teacher Phone * Have you participated in a GSP Lesson before? * Yes No Grade Level * Total Number of Students * Special Needs (Example: mobility, ELL, etc.) * Lesson Title * Advanced Maples: Grades 3-4; 2 hours Animal Signs; Grades 2-3; 2 hours Birds, Birds, Birds: Pre-K-1st; 90 minutes Birds, Birds Birds: Grades 2-3; 2 hours Exploring the Outdoors: Pre-K-1st; 90 minutes Here Comes Winter; Pre-K-2nd; 90 minutes Insects: Grades 2-4; 2 hours Marvelous Maples: Pre-K-2nd; 1 hour Stream Life: Grades 3-4; 2 hours Winter Challenges & Snowshoeing: Grades 3-8; 2 hours World of Pond: Grades 5 and up; 2 hours Unit Being Studied * At what point are you in the unit? * Starting Point Mid Unit Conclusion Dates Requested: Provide 3 dates in order of preference. Date 1 * Date 2 * Date 3 * Arrival Time (no later than 2:00 pm) * Will you bring a snack to eat along the trail? * Yes No Will you be staying for lunch? * Yes No How will you fund your visit? * PTO/PTA Check NY Connect Kids Reimbursement Grant Friends Scholarship BOCES Arts in Education and Exploratory Enrichment Program
