VFT REGISTRATION FORM AND
SURVEY Please fill out every field to
help us better serve you by having complete and
accurate information.
Contact CSA for information on how to
register if you experience difficulties
completing the registration form and survey.
YOUR INFORMATION
Name:
Your Email:
Grade/ Teaching
SCHOOL INFORMATION
School Name:
School Phone*:
*Must be a number we could call on the day
of the VFT in the event we need to contact you
or someone at your school
Principal:
Principal's Email:
Tech Coordinator:
Tech Phone:
VFT INFORMATION
*Teachers and administrators, please choose a VFT
and preferred time of day when registering and you will be contacted by email or phone with program availability.
Choose Your VFT:
Pierre Cruzatte: Fiddler on the Trail with Lewis and Clark
Tune-Up a Tale: The Lion and the Mouse
Tune-Up a Tale: Twilight Crane
Celtic Music Traditions
DIVA The Jazz Orchestra
MU Pickled Pepper Players Present: Bullies and School Safety
MU Pickled Pepper Players Present: Obesity and Overweight
Preferred Time of Day:
Morning Times
Afternoon Times
Other Attendees:
Total # of Students
(The recommended maximum number of students25 .)
Virtual Field Trip presenters will
expect that activities and lesson plans
relating to their topics will have been
completed prior to the VFT and that students
will be prepared to interact with the
presenter. Remember that there will be a
post-test as well as follow-up activities
that will complete the arts experience, most
of which will encourage submission to CSA.
We look forward to receiving materials that
will be posted on our web site.
Remember that your access to materials
related to the VFT for which you have
registered will have a limited availability.
You will be assigned a password that will
give teacher access to the learning module
for the VFT for the time allowed for
completing the module.
Your registration will be complete when
you have filled in the following short
surveys and and click the submit button.
SURVEY - ARTS AND
TECHNOLOGY IN MY CLASSROOM This is a brief survey designed to help us
understand the usage of fine arts and technology
in our schools. All responses will remain
confidential and will only be used to provide
quality virtual field trip experiences.
1. Have you ever participated in a Virtual Field
Trip?
2. How do you incorporate music concepts
or CSO's in your class?
How many minutes per week do you devote to
music?
10 - 20
20 - 30
30 - 40
40 - 50
Over 50
3. How do you incorporate art concepts or CSO's
in your class?
How many minutes per week do you devote to
art?
10 - 20
20 - 30
30 - 40
40 - 50
Over 50
4. How do you incorporate dance concepts or CSO's
in your class?
How many minutes per week do you devote to
dance?
10 - 20
20 - 30
30 - 40
40 - 50
Over 50
5. How do you incorporate theatre concepts or CSO's
in your class?
How many minutes per week do you devote to
theatre?
10 - 20
20 - 30
30 - 40
40 - 50
Over 50
6. How do you incorporate technology concepts or CSO's
in your class?
How many minutes per week do you devote to
technology?
10 - 20
20 - 30
30 - 40
40 - 50
Over 50
7. Please give a list of technology that is
representative of what you
8. Please describe your latest art project. What
resources are used?
Please rate your comfort with use of the arts in
your class on a scale 5 - Completely comfortable - could teach others
how to use this art in
SURVEY -
TECHNOLOGY This is a brief survey designed to help us
understand your level of comfort with various
sources of technology. All responses will remain
confidential and will only be used to provide
quality virtual field trip experiences.
Please indicate your level of comfort on a scale
of 1 to 5 with:5 - Completely comfortable -
could teach others about this program or
Also, please check
the box for "Yes" if you have ever used this
software/resource.
Comments regarding classroom technology:
Students
