NLSA Member Survey

We are updating our membership roster and recruiting new members. Membership is currently free, but we need your contact information as we are making a directory and asset map. This survey should take less than 10 minutes to complete. Thank you!

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* 1. Please enter your contact information. Include Company if you are representing your organization. If not, you may leave that section blank.

Name

Company

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 2. Do you have any alternate contact information you'd like to share?

Alternate email

Alternate phone

Other

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* 3. What is the best way to send you communications?

Facebook

Website

Mailchimp

Other (please specify)

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* 4. What is your website (if applicable)?

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* 5. What category/categories of "stakeholders" do you identify yourself with? (please check all that apply)

Non-profit organizations

STEM-expert organizations

Organizations emphasizing the arts

Formal PreK-12

Home school

Post-secondary organizations

Government

Professional organizations

Businesses

Initiatives

Museums

Career building organizations

Youth-based organizations

Charity and/or funding organizations

Out-of-School Time organizations (eg., afterschool, summer camps)

Other non-formal or informal STEM/STEAM based organization

Other (please specify)

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* 6. What are your "superpowers" (ie., things you can share with the NLSA)?

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* 7. What activities or products are your organization sharing in for distance learning?

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* 8. What would you like to gain from your membership in the NLSA?

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* 9. Are there any new members you'd like to suggest? If so, please enter their contact information below.

Name

Company

Email Address

Phone Number

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* 10. If you have any more suggestions regarding membership, please write to us at nlastemalliance@gmail.com

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* 11. Do you think we should assess a annual membership fee to support assistance with communications, database management, events, and other capacity-building needs? If so, please enter suggested amounts under each category.

Individual membership

Organizational membership

Sponsorships

Other