Please don't fill out this input box. Personal Information Last Name* First Name* Middle Initial Preferred Pronoun* He/Him She/Her They/Them Other Prefer not to say If selected other, please specify Street address* City* State* Zip Code* Phone number* Student email (Personal)* Student email (School)* Student T-Shirt Size* XS S M L XL XXL XXXL Primary Parent Name* Primary Parent Email* Primary Parent Emergency Contact Phone Number* Secondary Parent Name* Secondary Parent Email* Secondary Parent Emergency Contact Phone Number* Student details High school* Current Year in School* Please Select Freshman Sophomore Junior Senior School district* School Contact Person Please Select Counselor Teacher Organization advisor/sponsor Other If selected other, please specify Last name of School Contact* First name of School Contact* School Contact Email* Principal Name* Principal Email* Organizations/groups you participate in What you are interested in teaching Early Childhood Education (Pre K- 3rd grade) Elementary Education (1st-6th grades) Middle School (6th-9th grades) High School High School-Math High School-Science High School-Social Studies High School-Communication Arts/English Special Education Other (please specify below) If selected other, please specify Allergies or Dietary Restrictions* Please complete a 500 word essay about why you want to become a teacher and why you want to attend #BearsTeach 2025* Hidden Item Form UUID Site Name Submit Clear
