Please fill out this form to complete your Betabox Guide profile. 1School Information2My Information3Final Questions HiddenSource HiddenCampaign School Name Unique IDState(Required)In which state is your school located?(Select State)AlabamaAlaska (Unavailable)ArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaii (Unavailable)IdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingCounty (SC)(Required)In which county is your school located?(Select County)AbbevilleAikenAllendaleAndersonBambergBarnwellBeaufortBerkeleyCalhounCharlestonCherokeeChesterChesterfieldClarendonColletonDarlingtonDillonDorchesterEdgefieldFairfieldFlorenceGeorgetownGreenvilleGreenwoodHamptonHorryJasperKershawLancasterLaurensLeeLexingtonMarionMarlboroMcCormickNewberryOconeeOrangeburgPickensRichlandSaludaSpartanburgSumterUnionWilliamsburgYorkCounty (NC)(Required)In which county is your school located?(Select County)AlamanceAlexanderAlleghanyAnsonAsheAsheboroAveryBeaufortBertieBladenBrunswickBuncombeBurkeCabarrusCaldwellCamdenCarteretCaswellCatawbaChathamCherokeeChowanClayClevelandColumbusCravenCumberlandCurrituckDareDavidsonDavieDuplinDurhamEdgecombeForsythFranklinGastonGatesGrahamGranvilleGreeneGuilfordHalifaxHarnettHaywoodHendersonHertfordHokeHydeIredellJacksonJohnstonJonesLeeLenoirLincolnMcDowellMaconMadisonMartinMecklenburgMitchellMontgomeryMooreNashNew HanoverNorthamptonOnslowOrangePamlicoPasquotankPenderPerquimansPersonPittPolkRandolphRichmondRobesonRockinghamRowanRutherfordSampsonScotlandStanlyStokesSurrySwainTransylvaniaTyrrellUnionVanceWakeWarrenWashingtonWataugaWayneWilkesWilsonYadkinYanceyWe have a great new program available to North Carolina schools! Learn More. My Name(Required) Dr.Mr.Mrs.Ms. Prefix First Last Email(Required) Phone(Required)Extension TitleWhat is your current position at the school? Current Role(Required)Select the role that most closely describes your role. (Select Role)District OfficeSchool AdministratorSTEM EducatorCTE EducatorGeneral Studies EducatorOtherHow many schools are you submitting this application for?(Select)12345+If more than one school, please list the schools you're submitting an application for below. Is Your School Designated Title I? Yes Not sure No Estimated Current Student EnrollmentHow many students are at your school? This can be a best estimate! Estimate your School's Economically Disadvantaged percentageOur programs are typically prioritized for schools with more than 50% economically disadvantaged students. Note: We recognize that officially stated school report card data may not accurately reflect the unique makeup of your school community. If your estimate differs significantly from publicly available data, please share how you determined the percentage you provided. Describe how a Betabox Program could help your students and teachers.Betabox offers hands-on STEM engagement opportunities for students to learn about engineering, technology, and science with Onsite Field Trips. We also offer complimentary memberships for teachers to our K12 platform, Classbox.com, to access various lesson plans and request hands-on materials (including game design, coding, animation, and more!) and professional development. How Did You Hear About Us? From another school or from my district I received an email from Betabox Social media (Facebook, LinkedIn, Instagram, Twitter) A promotional or community event that Betabox was at Other Next Steps: Contact NameWho may we reach out to to schedule a program kickoff call and select dates for Betabox to come to your school? A science or CTE teacher is a good starting place! Contact EmailWhat is the email of your identified contact? Contact NumberWhat is the phone number of your identified contact? Other Betabox Program OptionsEnrolling your school in our funded programs is our top priority! If we are unable to enroll your school in one of our funded programs, would you be interested in being contacted about our district-funded program options? Yes No Additional Contacts for District-Funded Program OptionsPlease share the contact information of those who you would like to also be included in this email. Δ
