Sign Up
for International Dot Day 2013

and Download our free Educator's Handbook!

In order for us to better plan the events around International Dot Day and to be able to include as many people as possible, we are asking for you to fill out this brief survey. We are anticipating the largest International Dot Day ever and appreciate your help in spreading the word.

Please feel free to share this form with friends and colleagues who might like to join us for this annual celebration of creativity!

Required fields marked with *

First Name*

Last Name*

Email*

Organization Information

Organization Name*

Organization Type*

If other, please specify.

Location Information

City*

Select a Region* US

Select a State*

Canada

Select a Province*

Outside US and Canada

Select a Country*

Zip or Postal Code

Participants

Estimated Number of Participating Students/Youth/Children*

Estimated Number of Participating Adults*

Estimated Number of Participating Classrooms*

Celebration

Will you celebrate Dot Day in conjunction with a particular academic discipline/subject?

For Windows: Hold down the control (ctrl) button to select multiple options
For Mac: Hold down the command button to select multiple options

If other, please specify.

If applicable, please indicate the grade level of student/youth participants.

For Windows: Hold down the control (ctrl) button to select multiple options
For Mac: Hold down the command button to select multiple options

Please list multimedia tools you intend to use.

Briefly describe your plans, including any specific goals/outcomes you have in mind.
Goals/outcomes could be academic, social, developmental or related to civic engagement or organization culture.

Connecting!

Are you interested in connecting/collaborating with other Dot Day participants via email?* Yes
No

Please indicate whether you would like to receive occasional e-mails with news and information from the following:*

For Windows: Hold down the control (ctrl) button to select multiple options
For Mac: Hold down the command button to select multiple options

After signing up, download our free Educator's Handbook for International Dot Day, with student handouts by Peter H. Reynolds and awesome Dot Day activities by creative educators!

Sign Up
for International Dot Day 2013

and Download our free Educator's Handbook!

Organization Information

Location Information

Participants

Celebration

Connecting!

Get Involved! All Year!

Dot Day Partners 2013

Sign Upfor International Dot Day 2013

and Download our free Educator's Handbook!

Organization Information

Location Information

Participants

Celebration

Connecting!

Get Involved! All Year!

Dot Day Partners 2013

Sign Up
for International Dot Day 2013