BEAM Network Launch Interest Survey

Thank you for your interest in the BEAM Network (Belonging • Empowerment • And • Mentorship).

We’re building a supportive space for teachers in Southwestern PA to foster belonging, collective leadership, and mentorship.

This short form (8–10 questions) will help us understand your interest in participating or facilitating.

Contact Information

First Name

Last Name

Preferred Email Address Type

To ensure you receive Teach Plus communications promptly, we strongly recommend using a personal email address.

Work/School Email

Confirm Email Address

Personal Email

Confirm Email Address

Current School District or Charter School

Name of your current school(s)

Please write out the complete name.

Current Teaching Role

If "Other", please explain

Grade Level Currently Teaching

What grade(s) are you currently teaching?

Hold control (PC) or command (Mac) to select multiple grades

What subjects(s) are you currently teaching?

Hold control (PC) or command (Mac) to select multiple grades

Number of years of service as a teacher

PPID Number (Facilitator and Participants may be eligible for Act 48 hours)

Have you participated in any other programs with Teach Plus? If so, please list them.

Preferred Email

Demographic Information

Ethnicity

Select all that apply. To select multiple responses on a PC hold "Ctrl", on a Mac hold the Command key (next to the space bar).

If "Ethnicity not listed" is selected, please specify

Tribal Affiliation (Optional):

Area of Interest

I am most interested in joining BEAM as a:

ParticipantFacilitator

Open Reflection

Is there anything else you would like us to know about your interest in BEAM?

Next Steps

Thanks for your interest in becoming a BEAM facilitator!

1. Please take a moment to open and complete the Facilitator Application!

2. Please choose an informational session you can attend if you'd like to attend to learn more? Please select a date that works best for you!!