The i2P Youth Expedition to India - School Registration

Please note that all information provided is for i2P use only and will under no circumstances be shared with third parties.

1. Please provide the following information

Name of School:

Address:

City :

Country:

School Phone:

2. School Contact:

First Name:

Last Name:

Email Address:

Phone Number:

3. Your School is a(n):

--None--Elementary School Middle School High School Post-Secondary Other

4. Please tell us about your school:

Number of Teachers:

Number of Students:

5. How many students from your school will be participating in the i2P Education Program?:

6. Has your school participated in a previous i2P Expedition?:

--None--Yes No

7. Please provide a brief biographical sketch of your school:

8. If your class is interested in video conferencing, which of the following apply to your school?:

--None--Windows 7 Windows XP Macintosh 10.4 Macintosh 10.5 Macintosh 10.6 Other

9. If applicable, Please provide the Web Link for your school/school board:

10. How did your hear about impossible2Possible (i2P) or the expedition education resource?:

11. If you have any questions/suggestions please note them here:

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