2023-2024 SWITCH Registration
Are you a new or returning school to SWITCH?
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New, this will be our first year!
Returning, we are back for another year!
Name of School
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County
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Adair
Adams
Allamakee
Appanoose
Audubon
Benton
Black Hawk
Boone
Bremer
Buchanan
Buena Vista
Butler
Calhoun
Carroll
Cass
Cedar
Cerro Gordo
Cherokee
Chickasaw
Clarke
Clay
Clayton
Clinton
Crawford
Dallas
Davis
Decatur
Delaware
Des Moines
Dickinson
Dubuque
Emmet
Fayette
Floyd
Franklin
Fremont
Greene
Grundy
Guthrie
Hamilton
Hancock
Hardin
Harrison
Henry
Howard
Humboldt
Ida
Iowa
Jackson
Jasper
Jefferson
Johnson
Jones
Keokuk
Kossuth
Lee
Linn
Louisa
Lucas
Lyon
Madison
Mahaska
Marion
Marshall
Mills
Mitchell
Monona
Monroe
Montgomery
Muscatine
O'Brien
Osceola
Page
Palo Alto
Plymouth
Pocahontas
Polk
Pottawattamie (East)
Pottawattamie (West)
Poweshiek
Ringgold
Sac
Scott
Shelby
Sioux
Story
Tama
Taylor
Union
Van Buren
Wapello
Warren
Washington
Wayne
Webster
Winnebago
Winneshiek
Woodbury
Worth
Wright
School Mailing Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
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-
Area Code
Phone Number
Building Level
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Elementary School (grades 4-5)
Middle School (grades 6-8)
Both (combination of grades across both levels)
Indicate which grades will be participating and how many classrooms and total number of students from each respective grade level. (Best practice recommends all classrooms in the grade level participate together.)
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Participating
Total # of Classrooms
Estimated # of Total Students
4th
1
2
3
4
5
6
7
8
5th
1
2
3
4
5
6
7
8
6th
1
2
3
4
5
6
7
8
7th
1
2
3
4
5
6
7
8
8th
1
2
3
4
5
6
7
8
Back
Next
School Administrator Contact (principal of school building, superintendent, etc.)
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First Name
Last Name
School Administrator Email
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example@example.com
Core Team Leader Contact (This is the lead school staff member who will coordinate the school core team.)
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First Name
Last Name
Core Team Leader Email
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example@example.com
School Core Team Member Information: (List your main school team contact as the Core Team Leader. It is recommended to have at least 3 team members from various settings in the school. It is okay if you don't have them all confirmed yet, but please list those that you have identified so far.)
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First Name
Last Name
Email
Role in School
Core Team Leader
PE Teacher
Nurse
Food Service Department
Teacher (4th grade)
Teacher (5th grade)
Teacher (6th grade)
Teacher (7th grade)
Teacher (8th grade)
Curriculum Instructor
Paraprofessional
Principal or Other Admin
Computer/Tech Teacher
Guidance Counselor
Parent
Other
Team Member #2
PE Teacher
Nurse
Food Service Department
Teacher (4th grade)
Teacher (5th grade)
Teacher (6th grade)
Teacher (7th grade)
Teacher (8th grade)
Curriculum Instructor
Paraprofessional
Principal or Other Admin
Computer/Tech Teacher
Guidance Counselor
Parent
Other
Team Member #3
PE Teacher
Nurse
Food Service Department
Teacher (4th grade)
Teacher (5th grade)
Teacher (6th grade)
Teacher (7th grade)
Teacher (8th grade)
Curriculum Instructor
Paraprofessional
Principal or Other Admin
Computer/Tech Teacher
Guidance Counselor
Parent
Other
Team Member #4
PE Teacher
Nurse
Food Service Department
Teacher (4th grade)
Teacher (5th grade)
Teacher (6th grade)
Teacher (7th grade)
Teacher (8th grade)
Curriculum Instructor
Paraprofessional
Principal or Other Admin
Computer/Tech Teacher
Guidance Counselor
Parent
Other
Team Member #5
PE Teacher
Nurse
Food Service Department
Teacher (4th grade)
Teacher (5th grade)
Teacher (6th grade)
Teacher (7th grade)
Teacher (8th grade)
Curriculum Instructor
Paraprofessional
Principal or Other Admin
Computer/Tech Teacher
Guidance Counselor
Parent
Other
Team Member #6
PE Teacher
Nurse
Food Service Department
Teacher (4th grade)
Teacher (5th grade)
Teacher (6th grade)
Teacher (7th grade)
Teacher (8th grade)
Curriculum Instructor
Paraprofessional
Principal or Other Admin
Computer/Tech Teacher
Guidance Counselor
Parent
Other
If there are additional team members, please put their information here:
There are a variety of SWITCH program offerings your school can opt into this year that will provide additional opportunities. Please select those that you'd be interested in and would like to be contacted with more information. This helps us have a better idea of how many supplies or financial assistance we'll need to fund to support the implementation of these experiences.
SWITCH Youth Ambassador Team: Engaging student leaders to introduce healthy habit activities with their peers.
Soccer for Success for PE: This is a 10 lesson unit curriculum helping youth build essential character skills (teambuilding, goal setting, overcoming challenges, relationship building) through practicing the sport of soccer.
SWITCH Cooking School: Would you have interest in offering a virtual family cooking series. Trained facilitators would Zoom with up to 8 families per month January-April.
Shine Light on Depression: A mental well-being curriculum (3 lessons) to help students explore their mental health and the techniques in their toolbox to practice skills to address stress or strong emotions in a healthy way.
SWITCH is all about transforming the school wellness environment, which includes your School Wellness Policy. Please upload your school's wellness policy here. (Every school participating in the National School Lunch Program has a wellness policy. If you are not sure where to locate yours, please contact your school administrator). **Returning Schools: If you updated your School Wellness Policy this school year, please upload your most recent one on file.**
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