Global Up Americas - Teacher Registration Form

1
Name* This field is required.
First Name
Last Name
2
Email* This field is required.
example@example.com
3
Phone Number* This field is required.
Please enter a valid phone number.
4
School Name* This field is required.
5
School Address* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
6
School Profile Information* This field is required.Please select the category that best describe the percentage of students who qualify for Free/Reduced Lunch.
75% or more
Between 50-75%
Between 25-50%
Less than 25%
Other
7
Cultural Diversity Breakdown* This field is required.Please enter the percentage of your building's student population that most closely identifies with each of these cultural groups.
White/Caucasian
Hispanic/Latino
Black/African American
Asian
American Indian /Alaska Native
Native Hawaiian/Pacific Islander
Other (Not included above)
8
In what time zone is your school?* This field is required.
Eastern
Central
Mountain
Pacific
Alaska
Other
9
In what language(s) would you like to have your students learn and contribute in this exchange?* This field is required.Please select all options that you are willing to support.
English only
Spanish only
English/Spanish Combo
I'm flexible
10
In what months could you participate in this virtual exchange with students?* This field is required.Please select all possible options (even if that includes a partial month).
September
October
November
December
January
February
March
April
May
11
In which semester would you like your class(es) to participate in the exchange.* This field is required.Please select any that apply.
Spring semester 2024
Fall Semester 2024
Spring semester 2025
12
Are ALL of the students that you want to have participate in this exchange 14 years old or older?* This field is required.The minimum student age for participation is 14 years old.
YESNO
13
What subject(s) do you teach?* This field is required.Please indicate the class subject(s) that you intend to engage in this virtual exchange. Please be specific.
14
How many class sections would you like to have participate in this exchange?* This field is required.For example, 2 sections of Spanish IV or 1 section of World History. Details are helpful!
15
Do you still want to participate even if only one of your classes can be matched up for this exchange?* This field is required.This is a VERY likely scenario of this program given the high interest in this content and program.
YESNO
16
What is the number of students you have in EACH CLASS (not total) that you want to have participate?* This field is required.For example, Spanish III (1st period) has 28 students & Spanish V (5th period) has 17 students. Please be specific.
17
What time would your participating class(es) meet?* This field is required.If the class times change for the spring semester, please indicate that here as well. Details are helpful.
18
What technology will your students have access to for joining the live dialogue sessions during the school day?* This field is required.For example, are you a 1:1 school where every student has an iPad or laptop, will you be scheduling time in a computer lab or access to a mobile laptop cart, will students be connecting with their phones, will you project the other classroom from the front of the room and have full group discussions?
19
Has your building or district leadership approved your participation in this exchange experience yet?* This field is required.School administrators and participating teachers will be asked to sign a committment form for this program.
Yes, they're fully aware and supportive.
Likely, but I still need to get a little more information.
Maybe, but there are a lot of questions or hesitancy.
I have not spoken with my building/district leaders yet to get their approval, but I imagine it will be fine.
I have not spoken with my building/district leaders yet to get their approval and I'm unsure of their reaction.
Other
20
What do you hope to accomplish with this virtual exchange experience?* This field is required.
Huge
Large
Normal
Small
Ok
Ok
21
How flexible are you when it comes to the start date, times of day, and/or the months in which you and your students participate in this exchange?* This field is required.
22
Important Information to Note* This field is required.
I understand that I will be asked to go through the Global Up Educator Program (online modules & live dialogue sessions) to become a Qualified Facilitator for the Global Up Teen program and have an understanding of the content for the exchange. (I will receive a certificate of 20 professional growth hours for this.)
I understand that the student/classroom exchange component may take on different forms (1:1 communication between students, small breakout groups, whole class discussions) based on the technology available and class sizes in my partner's school and mine.
I understand that I may opt to participate in both the 2023-2024 and 2024-2025 school years if I will have different students participating each year.
I understand that flexibility is important as there is a strong possibility that class times and schedules will not be a perfect match between my partner's classroom and mine.
I understand that I may need to get formal administrative approval to participate in this program.
I understand that once I am partnered with a classroom abroad and approve of the pairing, I must follow through as there are grant funds tied to the resources and time of all involved. (Don't worry, we're not there yet!)
23
Please use the emoji to indicate your level of desire to participate in this virtual exchange! * This field is required.
Row 0, Column 0Row 0, Column 1Row 0, Column 2Row 0, Column 3Row 0, Column 4
Row 0, Column 0Row 0, Column 1Row 0, Column 2Row 0, Column 3Row 0, Column 4
24
What questions, if any, do you have for AFS-USA?
25
How did you learn about the AFS Global Up Americas virtual exchange opportunity?* This field is required.Please be specific about who sent you an email, where you learned about it, etc...
Should be Empty: