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 Will you be attending one of our IIP Invention Convention PDs? If so, please indicate which one you plan to attend. We will send you the invite. Thursday, Jan. 5, 2023. 6:30-8:00 PM EST Monday, Jan. 9, 2023. 6:30-8:00 PM EST No, I will not be attending an IIP Invention Convention PD. 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