Independent Inventor Program: Intent to Participate First Name Last Name Email Confirm Email Phone Number Your Preferred Form of Communication Email Phone Text Other... This choice will expand a text box Your Role Teacher Parent School Administrator Scout Leader After School Program Teacher After School Program Administrator Extra-Curricular Program Facilitator Homeschool Educator Student (If part of a team, please write your team name in the "Other" Category) Other... This choice will expand a text box Your State Name of your School/Program Participating in the Independent Inventor Program Estimated # of Student Participants in your program through you directly (e.g., just your 18 classroom students). (If you are a parent, how many of your children will be participating?) Estimated # of Student Participants in your larger program as a whole (e.g., the # of students in your entire K-3 program, given that the other teachers are doing this with you). If you are not part of a larger program, please enter "N/A." Have you participated in an Invention Convention before? Yes No I'm not sure Other... This choice will expand a text box If "yes" you have participated in an Invention Convention before, please let us know which program and briefly describe your experience. (e.g., "I was a 2nd grade teacher who sent my top students to participate in the Massachusetts Invention Convention and 2 of my students escalated to participate in the Invention Convention U.S. Nationals in 2022"). Grade Level You Teach/Facilitate (check all that apply) (If you are a parent, please check the grades of your participating students). Pre-K K 1 2 3 4 5 6 7 8 9 10 11 12 Other... This choice will expand a text box If you are interested in judging or have people you'd like to invite to judge, please indicate that here. Yes, I would like to judge. I have other adults I'd like to invite to judge. I would like to learn more about judging. No thank you. Other... This choice will expand a text box Submit Close popup Close popup Close popup Close popup Close popup