Ignite Ambassador Registration Form

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Ignite Ambassador Registration Form

The Capital Area STEM Network (CASN) and the LSU Gordon A. Cain Center for STEM Literacy (Cain Center) are seeking qualified individuals from public schools and public charter schools to serve as ambassadors for The Ignite Project. These selected individuals will be responsible for:

participating in 40 hours of training, divided across four 8-hour biweekly sessions. The first and last session will take place in person. The second and third sessions will take place virtually. There will also be four 2-hour virtual support sessions between each of the four 8-hour trainings.
redelivering this 40-hour training to others. Please complete the fields below if you are interested.

Administrative approval is required.

Participant's Name*

First Name

Last Name

Participant's School Email*

Participant's Personal Email*

Role*

Teacher Administrator

Other:

Work Phone*

Personal Phone

Do you work at a public school or public charter school?*

Administrator Approval Acknowledgement*

I have permission from my administration to participate as an Ignite Project Ambassador.

Please select a session.*

Wednesday, Jan. 3, 2024 - Region 5 STEM Center (Lake Charles) Saturday, Jan. 6, 2024 - South Louisiana Community College (Lafayette) Saturday, Jan. 6, 2024 - Louisiana State University (Baton Rouge) Saturday, Jan. 6, 2024 - Tulane University (New Orleans) Saturday, Jan. 6, 2024 - Louisiana Tech University (Ruston)

IGNITE Registration Form

Unfortunately, The IGNITE Project is only available for Louisiana public schools and public charter schools. For more information on Code.org trainings for all elementary school teachers, please visit https://code.org/professional-development-workshops.

Would you like more information regarding other elementary teacher training programs?*

Yes No

District*

Other District:*

Additional Information

School Name*

School Address*

Address Line 1

Address Line 2

City

State

ZIP Code

School Administrator's Name*

First Name

Last Name

School Administrator's Email*

School Administrator's Phone*

What grade level(s) are you teaching this year?*

PreK K – 1 2 – 3 4 – 5

Other:

What subject(s) do you teach?*

Math Science ELA Enrichment

Other:

Do you have previous experience with Code.org, computer science, or project-based learning in STEM?

Yes No

Please indicate your comfort level with each of the following. (5 = Most Comfortable; 1 = Least Comfortable)

Please indicate your comfort level with each of the following. (5 = Most Comfortable; 1 = Least Comfortable)
	1	2	3	4	5	N/A
CS Fundamentals	Please indicate your comfort level with each of the following. (5 = Most Comfortable; 1 = Least Comfortable): CS Fundamentals (1)	CS Fundamentals (2)	CS Fundamentals (3)	CS Fundamentals (4)	CS Fundamentals (5)	CS Fundamentals (N/A)
Scratch	Scratch (1)	Scratch (2)	Scratch (3)	Scratch (4)	Scratch (5)	Scratch (N/A)
ScratchJr	ScratchJr (1)	ScratchJr (2)	ScratchJr (3)	ScratchJr (4)	ScratchJr (5)	ScratchJr (N/A)
Micro:Bit	Micro:Bit (1)	Micro:Bit (2)	Micro:Bit (3)	Micro:Bit (4)	Micro:Bit (5)	Micro:Bit (N/A)
Finch 2.0	Finch 2.0 (1)	Finch 2.0 (2)	Finch 2.0 (3)	Finch 2.0 (4)	Finch 2.0 (5)	Finch 2.0 (N/A)
Birdbrain Hummingbird Kits	Birdbrain Hummingbird Kits (1)	Birdbrain Hummingbird Kits (2)	Birdbrain Hummingbird Kits (3)	Birdbrain Hummingbird Kits (4)	Birdbrain Hummingbird Kits (5)	Birdbrain Hummingbird Kits (N/A)
Machine Learning	Machine Learning (1)	Machine Learning (2)	Machine Learning (3)	Machine Learning (4)	Machine Learning (5)	Machine Learning (N/A)
Cyber.org	Cyber.org (1)	Cyber.org (2)	Cyber.org (3)	Cyber.org (4)	Cyber.org (5)	Cyber.org (N/A)

Agreements

Consent to Share Information*

I consent to sharing the information provided in this application with the LSU Gordon A. Cain Center for STEM Literacy, the Capital Area STEM Network, and their partners as necessary to facilitate the IGNITE program. This data will be securely retained indefinitely. To learn more about privacy at LSU, please see the LSU Privacy Statement (https://www.lsu.edu/privacy/).

Consent to Receive Announcements*

I understand, by submitting this form, I might be subscribed to future announcements about events and programs of Cain Center and/or Capital Area STEM Network, and that each such announcement will include a link to unsubscribe from future such announcements.

Acknowledgement of Commitment*

I understand that The Ignite Project is a 40-hour workshop consisting of four bi-weekly 8-hour sessions (two virtual and two in-person) and four 2-hour virtual support sessions.

Acknowledgement of Administrator Approval Requirement*

I understand that my registration as an Ignite ambassador will remain provisional pending approval from my administrator.

Please forward the following link to your administrator.

Administrator Approval Form: https://forms.office.com/Pages/ResponsePage.aspx?id=P61NLa5Q2UeDoJrisfRm-PCDyFdiCPRLla2A-PnRDSRUOFBVNVo1NkZGVTlOODU4Tjk2QUtKUVZVRS4u