First Name *

Last Name *

Email *

Country * US AF AX AL DZ AD AO AI AQ AG AR AM AW AU AT AZ BS BH BD BB BY BE BZ BJ BM BT BO BQ BA BW BV BR IO BN BG BF BI KH CM CA CV KY CF TD CL CN TW CX CC CO KM CG CD CK CR CI HR CU CW CY CZ DK DJ DM DO EC EG SV GQ ER EE ET FK FO FJ FI FR GF PF TF GA GM GE DE GH GI GR GL GD GP GT GN GW GY HT HM VA HN HU IS IN ID IR IQ IE IM IL IT JM JP JE JO KZ KE KI KP KR KW KG LA LV LB LS LR LY LI LT LU MO MK MG MW MY MV ML MT MQ MR MU YT MX MD MC MN ME MS MA MZ MM NA NR NP NL NC NZ NI NE NG NU NF NO OM OT PK PS PA PG PY PE PH PN PL PT QA RE RO RU RW BL SH KN LC MF PM VC WS SM ST SA SN RS SC SL SG SX SK SI SB SO ZA GS SS ES LK SD SR SJ SZ SE CH SY TJ TZ TH TL TG TK TO TT TN TR TM TC TV UG UA AE GB UY UZ VU VE VN VG WF EH YE ZM ZW

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District *

Position * Teacher Dept Chair Superintendent/District Administrator Curriculum & Instruction Purchasing/Accounts Payable/Admin Parent Principal/Asst. Principal Other Tech Support

I have everything I need to implement my product without further support. * Yes No

I would like to learn about one or more of the following self-paced professional learning options for teachers in my district. Check all that apply. Active Classroom Certification CoursesYoung Citizen Certification CoursesSocial Studies School Service Micro-credential Program

I would like to learn more about one or more of the following Professional Learning Menu Options for TEACHERS. Check all that apply. Plan, Practice, Teach: Preparing for Effective Social Studies InstructionDifferentiation for AllThis is Disciplinary LiteracyThe Art of Reading Non-FictionCultivating Student Writers in Social Studies ClassroomsRedefining the Literacy BlockFormative Assessment in Social StudiesThe Ideal Elementary Self-Contained ClassroomIt All Starts With GeographyUsing the Case Study Approach to Human Geography

I would like to learn more about one or more of the following Professional Learning Menu Options for LEADERS. Check all that apply. Foundations of Effective Social Studies LeadershipInstructional Coaching for Social StudiesFormative Assessment in Social Studies

I would like to learn more about how I might collaborate with Social Studies School Service to customize professional learning in my district. Yes No

I would like to learn more about one or more of the following ways Social Studies School Service might support our district with curriculum development and implementation. Check all that apply. Guidance and coaching for developing district-wide curriculum resources that include our resourcesResources to facilitate professional learning communities (PLCs)Support with the planning, facilitation, and reflection of instructional rounds focusing on curriculum and resource implementationDeveloping measurements of implementation success (i.e., surveys, focus groups, action research)Customized support available upon request and availability

I would like to learn more about one or more of the following ways Social Studies School Service might serve as a thought partner to support my role as a leader. Check all that apply. Supporting vision, mission, and goal setting for social studiesSupporting the development of district stakeholders (i.e., instructional coaches, assistant principals, Tier II leaders, etc.)Supporting the planning, facilitation, and reflection of instructional roundsDeveloping measurements of implementation success (i.e., surveys, focus groups, action research)

I would like to learn more about how Social Studies School Services Teacher Leader Corps Program. Yes No

Are you interested in a one-hour planning and collaboration meeting to discuss your district’s personalized pathway towards the implementation of your newly procured resources? Yes No

What else do we need to know about your district? Example: What are some of the district initiatives worth mentioning? Is there a team of curriculum specialists and or instructional coaches that support social studies? Are there designated professional learning days/times?

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