CEP Summer 2017 Final Form

All About You

Please note that this final form should be your LAST step in this summer's program. If you still intend to complete other assignments or attend/watch other webinars, please complete this AFTER you have completed all summer learning.

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* 1. Please type your name exactly as it should appear on any documentation.

First

Middle (if desired)

Last

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* 2. Email

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* 3. What other email addresses (if any) did you use during this program to join a live webinar session or submit an assignment?

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* 4. If you logged into any webinar by phone, please note the phone number you used.

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* 5. Please tell us about yourself.

Role(s)

Subject(s)

School or District

State or Country

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* 6. What documentation are you seeking from CK-12?

Full CK-12 Certified Educator status (which includes a certificate of participation for webinars attended and work completed)

Certificate of participation for webinars attended and work completed

No documentation requested