Agriculture Instructor Form 1
School Year
*
School Name
*
Title
*
Teacher
Student Teacher
Name
*
First Name
Last Name
Your Home Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Birthdate (Month & Day)
Your Email
*
example@example.com
Cell Phone Number
*
-
Area Code
Phone Number
School/Ag Dept. Number
*
-
Area Code
Phone Number
Upload a photo for our directory
Browse Files
head shot preferred
Cancel
of
Years Teaching Ag
*
If you did not attend Summer Ag Teacher Conference, would you like to be billed for the NMAETA/NAAE dues?
Yes, Both.
NMAETA only
NAAE only
no, thank you
Superintendent's Name
Superintendent's Email
example@example.com
Business Office email
*
example@example.com (not Ag Teacher)
Business Office Contact
*
(not Ag Teacher)
Business Office Phone
*
-
Area Code
Phone Number
School Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Class Schedule:
Weekly Schedule:
*
5-Day Week
4-Day Week
Daily Schedule:
*
6 Period Day
7 Period Day
A-B Block
Modified Block
Lunch Break Time:
*
Prep Period Time:
*
Class 1: Course Title
*
STARS Code
*
Class 2: Course Title
*
STARS Code
*
Class 3: Course Title
*
STARS Code
*
Class 4: Course Title
*
STARS Code
*
Class 5: Course Title
*
STARS Code
*
Class 6: Course Title
*
STARS Code
*
Class 7: Course Title
*
STARS Code
*
Class 8: Course Title
*
STARS Code
*
Comments
Submit
Should be Empty: