Unmasked Sign-Up
Name
*
First Name
Last Name
Email
*
example@example.com
Which option best describes your role?
*
Please Select
Teacher - ELA
Teacher - Math
Teacher - Science
Teacher - Social Studies
Teacher - Special Education
Teacher - Generalist
Principal (or similar)
Student Support Personnel (Counselor, Transition counselor, Special Education Specialist, etc.)
Education Agency leadership (School District, Educational Nonprofit, County Office of Ed, etc)
Juvenile Justice Agency Leadership (DJJ, DYS, etc.)
Other
Which subject(s) are you teaching UNMASKED in?
*
ELA
Math
Science
Social Studies
What agency/organization employs you?
*
What is the name of the facility you work in?
*
What is the name of the school at your facility?
*
What state is your facility in?
*
Please Select
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
# of Students Participating
*
Filling out this form on or before Oct 31st? Would you like to receive a free class set of hero masks in the mail, plus an entry in our lottery for an Unmasked classroom kit?
Yes, please
No, thanks
Shipping address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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