MULTIPLY-EASY I LOVE M.E. Pilot Program Application
Apply for the MULTIPLY-EASY “I LOVE M.E.” pilot program by providing your organization details, pilot scope, and selected investment tier. Fields are optional unless marked required in the original document.
Applicant and Organization Information
Your Role
*
Teacher
School Administrator
District/Network Staff
Church/Religious Education Director
Other Educational Organization
If Other Educational Organization, please specify
Organization Type
*
Public
Private
Full Name
*
First Name
Last Name
Organization/School Name
*
Address
*
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Alternate Contact Information
Alternate Contact - Full Name
*
First Name
Middle Name
Last Name
Alternate Contact - Organization/School Name
Alternate Contact - Address
Alternate Contact - Email
example@example.com
Alternate Contact - Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Pilot Scope and Investment
Grade Level(s) you wish to target
*
Approximate Number of Students you wish to include in the Pilot Program
*
1-25
26-50
51-100
101-200
201+
Briefly tell us how you plan to use MULTIPLY-EASY in your curriculum
*
Pilot Investment Tier
*
Please Select
A
B
C
D
E
Authorization and Return Details
Signature
*
Date
*
-
Month
-
Day
Year
Date
Return Email Address
*
example@example.com
Sender Name
*
Submit Application
Submit Application
Should be Empty: