MT Empathy Interview Recruitment
First Name
*
Last Name
*
Email Address
*
Phone Number
*
Phone
Affiliation with Education
*
Teacher
School Administrator
District Administrator
Other Education Staff
Parent of K - 12 Student
K - 12 Student
Grade level affiliation
Primary (K - 2)
Elementary (3 - 5)
Middle Grades (6 - 8)
High School (9 - 12)
School district affiliation
*
Educators only - years of experience?
Less than 5 years
5 to 10 years
More than 10 years
Willing to participate in 30-45 minute video call?
*
Requires a computer or tablet for video conference.
Yes
No
Race
*
Alaska Native or Indigenous American
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
Two or more races
Prefer not to answer
Ethnicity
*
Hispanic or Latino
Not Hispanic or Latino
Prefer not to answer
Gender
*
Female
Male
Non Binary
Prefer not to answer
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