SVETN Contact Information
All information provided on this form is confidential and will be used strictly for the educational purposes of the Southwest Virginia Education and Training Network (SVETN).
 
Directions: Provide the following information on this form and click the 'Submit' button at the bottom of the page.
School Contact Information
  School Name:   A value is required.
  School Phone: A value is required.
  School Fax:
  Principal Name: A value is required.
  Principal Email: A value is required.Invalid format.
  Assistant Principal Name:
  Assistant Principal Email:
  Guidance Counselor Name: A value is required.
  Guidance Counselor Email: A value is required.Invalid format.
  Bell Schedule: Please select an item.
Course 1 Information* The following information should be provided for each ITV class within your school.
  Course or Class Name: A value is required.
  Instructor Name: A value is required.
  Instructor Location: A value is required.
  Instructor's Email: A value is required.Invalid format.
  Other Connected Schools: A value is required.
  Number of students enrolled (estimate if final numbers are not available): A value is required.
  Days Class Meets (e.g. Mon, Wed, Fri; Tues, Thurs, or All Week): A value is required.
  Date Class First Meets: A value is required.
  Expected End Date: A value is required.
  Time Class Begins: A value is required.
 

Time Class Ends:

A value is required.
*If your school offers more than one ITV course, you will be prompted to provide this additional information upon submitting this form by pressing the Submit button.
Survey -- Optional
 

Does all of the equipment in your ITV room currently function properly? If not, what needs our attention?
 
 
 

Are there any technical changes you would like see made to your ITV classroom? If so what?
 
 
  Are there any resources that SVETN could provide that would make operating as an ITV instructor easier?
 
 
Questions/Comments for SVETN