Living Lands & Waters Education Workshop Interest Sign Up Form

LLW Education Workshop Interest Sign Up Form

Whether you've been to our Floating Classroom on the barge with students, participated in an Educator Workshop, or just recently heard of Living Lands & Waters, this is the place to sign up for future education notifications!

Traveling America's Rivers, we offer multiple educational opportunities with the focus of protecting our freshwaters. Interested in being notified when we're on a river near you? Be sure to complete this form and we'll contact you with more information.
I am interested in signing up.... (CHOOSE 3):

My class/students for a Quad Cities based Student Education Workshop (ie: summer camp, which most likely will incorporate water based activities, as well)My class/students for a Student Education Workshop on the "Floating Barge" (river based)My class/students for a Virtual Education SessionTo schedule an in person guest speaking engagement with a LLW Educator (needs to be within appropriate traveling from the Quad Cities area)Myself for an Educator Workshop
Have you already participated in an education focused event with Living Lands & Waters before?*

YesNo
If yes, what event?*

n/a - I answered "no" aboveBarge based Student Education WorkshopEducator WorkshopLand based Student Education WorkshopVirtual Education SessionGuest Speaking EventOther
What type of Educator are you?

Formal - in a school settingNonformal - ie: nature centerHome School Student EducatorClub or Organization Leader - ie: Girl/Boy ScoutsOther
Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Email*
example@example.com
School Name, Group Name or Name of Current Work Location: *
School Address or Address of Current Job Location: *

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
What river are you closest located to (within 2 hours of driving)?*

Mississippi RiverOhio RiverIllinois RiverMissouri RiverWisconsin RiverTennessee RiverI am not located within 2 hours to a large river, like the ones stated above.
What grade level do you currently work with?
What subject/material do you teach? (ie: Biology, Environmental Science, STEAM, etc.)
Please enter today's date:

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Date
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