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First Name*
Last Name*
Phone*
Phone Type* CellWorkHome
Your email*
School*
School Address*
School Address 2
School City*
School State*
School Zip*
School Country*
School District
Number of Years Teaching*
Number of Years Participating in YHOP
Subject(s) You Currently Teach*
Grade Level(s) You Currently Teach*
PROGRAM PARTICIPATION INFORMATION
How many students do you expect to participate in the program? (if multiple teachers are joining from your school, please provide approximate number of total students)*
What grade level(s) from your school do you expect to participate in the program?*
Are there other teachers from your school that would also participate in the program?* YesNoMaybe
If yes, please include their names and email addresses here
Tell us why you are interested in participating in the Young Heroes Outreach Program*
Tell us how you currently incorporate civics learning in your classroom.*
Tell us how you currently incorporate community engagement in your classroom. (If possible, please list examples of partner organizations, projects, initiatives, etc.)*
Tell us about other year-long projects that are introduced in your classroom.*
How did you find out about the Young Heroes Outreach Program? (select all that apply)* I have participated in YHOP in the pastI was recommended to participate by another teacherI was recommended to participate by my principalI saw the program marketed on a website, social media, or email newsletterI learned about the program through America250PAI was connected through my school district or Intermediate Unit
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Adults: $25Children & Students free
673 12 Constitution Lane Massillon781-562-9355, 781-727-6090