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2. Teacher Name
3. Teacher Email
5. School or District
7. School Address
9. City
10. State
11. Zip
13. Grade Level(s)
14. Number of Participating Classes
15. Approximate Number of Participating Students
17. Preferred Semester
    -- Select One --Fall 2017Spring 2018Either
18. For the 2017-2018 school year, what is your first day back at school?
20. What goals or expectations do you have for a Murals and More project?
    Some teachers want help executing a particular project. Other teachers are looking for a fantastic place-based learning experience but don't have a particular result in mind. We've had success with both kinds of scenarios, but it helps us to know what you're looking for!
22. Is there anything else you'd like us to know about yourself, your students or your school/community as we consider your application?
24. How did you hear about Placeworks?
    -- Select One --Art Museum websiteCFO websiteFacebookbrochureanother teacher in my building shared infoword of mouthother
26. Thank you!
    We will be in touch regarding your application at the beginning of the 2017-18 school year. Because Placeworks dedicates significant resources to Murals and More projects, we want to be sure that what we have to offer is a good match for your needs. We will meet with qualifying applicants at their schools to discuss projects before making final selections. In the meantime, feel free to contact Kate Baird at kbaird@springfieldmo.gov with questions or concerns.
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28. 1. Receive an email copy of this form.
29. Email address

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