Become an American Graduate Champion 2014

Thank you for your interest in American Graduate Day 2014. We want to hear your story and what actions you are taking or would like to take to make a difference in your community and beyond. Please take a few minutes to share your story with us.

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* 1. Contact Information: (Required Fields)

First Name: *

Last Name: *

City/Town:

State:

ZIP Code: *

Email Address: *

Name of your PBS Station:

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* 2. How did you hear about American Graduate Day?

on this website

my local pbs station

word of mouth

from an organization for which I volunteer (list the name of the organization below)

other

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* 3. Did you watch some of the American Graduate Day 2014 broadcast?

Yes

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* 4. If you watched the broadcast, please write a sentence to share your thoughts about what you saw.

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* 5. Are you currently doing work in a volunteer or professional capacity that focuses on education, mentoring, dropout prevention and re-engagement and/or college and career readiness?

Yes

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* 6. Please list the name of the organization(s) for which you volunteer and/or work.

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* 7. Please describe the work you are currently doing for the organizations you listed above.

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* 8. Would you like to start doing something new (volunteer or paid), focusing on education, mentoring, dropout prevention and re-engagement, and/or college and career readiness?

Yes

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* 9. What area would you like to focus on? [Check all that apply.]

after-school programs

summer programs

early learners

mentoring

students with special needs

science, technology, engineering or math education

arts education (visual arts, music, theater, etc.)

dropout prevention

re-engaging students in education

college and career readiness

Other (please specify)

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* 10. We are celebrating Champions this year. Who is someone who has been a champion in your life and has helped you succeed? Please describe the role they have played in your life.

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* 11. Please add any additional thoughts or comments you would like to share about American Graduate Day 2014.

Thank you for completing this survey! By submitting your information, you are officially joining thousands of American Graduate Champions throughout the country who are making a difference in the lives of learners by sharing information, participating in discussions, and/or volunteering.