Event Contact Form
Event
*
Get on NRSC email list
N/A
VRC Tournament
IQC Tournament
ROV Tournament
Drone Tournament
VEX IQ Online Training
VEX VR Training
VEX VRC Training
VEX EXP Training
VEX IQ Training
3D Printer Training
CAD Training
Drone Training
IXL Training
ELA Strategies & Resources
STEM Academy Training
STEM & Literacy - Using the Dash Robot in ELA Instruction
ACT Prep
Bloxels Workshop
Intro To NRSC
Date of Training
*
-
Month
-
Day
Year
Date
Date of Training
*
Name
*
First Name
Last Name
Gender
*
Male
Female
Ethnicity
*
African American
Caucasian / White
Hispanic
Other
Prefer Not To Say
I am:
Deaf
Hard of Hearing
Deaf-Blind
Hearing
Prefer Not To Say
Email
*
example@example.com
Role
*
Student
Parent
Educator
Interpreter
Employer
VR
Other
Please explain your role
*
Title
*
Name of Business
*
Child's Full Name
*
First Name
Last Name
Grade Level
*
12th (Senior)
11th (Junior)
10th (Sophomore)
9th (Freshman)
8th
7th
6th
5th
4th
3rd
2nd
1st
K
Select all that apply:
*
Art Teacher
ASL Teacher
English Teacher
Math Teacher
Science Teacher
Social Studies Teacher
Teacher of the Deaf
World Language Teacher
Other Teacher
Athletic Coach
Academic Bowl Coach
Principal/Administrator
Service Coordinator
What is the name of your school/district?
*
What grade level do you work with? (check all that apply)
*
Elementary
Middle School
High School
Birth Date
-
Month
-
Day
Year
Date
Home Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Home Phone Number
-
Area Code
Phone Number
Your Mailing Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Business Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
-
Area Code
Phone Number
Setting You Interpret In (Check All That Apply)
*
Educational K-6
Educational 7-12
Post-Secondary
VRS
Freelance through an agency (not educational, but community)
Freelance, Direct Contract (not educational, but community)
State You Interpret In
*
T-shirt size (for ACT workshop)
S
M
L
XL
2XL
3XL
Please verify that you are human
*
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