Name *

First Name

Last Name

Mobile Phone

(###)

###

####

Please check off the boxes to tell us what specific actions you commit to:

I will attend my next school board meeting (in person) within the next month

I will make sure at least 3 more people from my district go through PSS Orientation so they are ready to join me at school board meetings in PSS shirts

I will report back from observing our next school board meeting using the PSS Report Form (or I will make sure someone I bring will submit it on my behalf)

I will attend school board meetings regularly through December 2025 (The larger your team, the more you can rotate!)

How would you describe the type of community you live in?

Urban

Suburban

Rural

What is your connection to your school district's schools? (Check all that apply) *

Parent of current or former public school student(s)

Family member of current or former public school student(s)

I'm a student

Educator

Work for the school system

Retired from working for the school system

School board member

Supporter of public schools because of their importance for a healthy, just, and multiracial democracy

I understand that my contact info will be shared with other trained and vetted PSS participants in my school district *

Yes

No