2023/2024 3rd Grade Classroom Visit Planning Form

2023/2024 3rd Grade Classroom Visit Planning Form

Form submission date*

School Name*

Select

School Address*

Teacher First and Last Name*

How many third-grade classrooms do you have?*

This interactive presentation empowers students to create a home escape plan with their families, practice a home fire drill and improve safety in their homes. This class is 60 minutes long, and we prefer to visit each classroom separately.

How many students are in each class?*

How many students/families will want materials in Spanish?*

Are there any students in your classroom whose primary language is not English or Spanish? If yes, please specify what language this student speaks at home.*

Do any students have a sensitivity to loud noises, like the sound of a smoke alarm? If yes, what can we do to help those students?*

Have any of the students experienced a home fire or had a serious burn injury?*

Yes

The Risk Reduction Specialist will need to be able to play the Sound Off videos for the class. Please select all that apply:*

The Risk Reduction Specialist will have internet access from the classroom computer to play the videos for the class

Please have the Risk Reduction Specialist bring their own computer to share multimedia.

Please have the Risk Reduction Specialist bring a thumb drive (USB) for the teacher to plug in and share from a classroom computer.

Please have the Risk Reduction Specialist email me links/attachments to play multimedia for the class.

Will the teacher share Sound Off digital resources with students and families by sending online access information home? (Check those resources the teacher will share.)*

The Sound Off Safety App for tablets and smart phones – downloadable for Android or Apple, or accessed through https://ymiclassroom.com/lesson-plans/sound-off-app/

The Sound Off videos – viewable at https://ymiclassroom.com/lesson-plans/soundoff-videos/

The Sound Off Storybook – available in all versions (see #8 above) at https://ymiclassroom.com/lesson-plans/sound-off-storybooks/

The Sound Off online game, Smoke Alarm Smarts, which can be played on a desktop or tablet computer at https://ymiclassroom.com/video/sound-off/smoke-alarm-smarts.html

Will the teacher make Sound Off digital resources listed above available for students on digital device(s) in the classroom after the Risk Reduction Specialist's classroom visits?*

Yes

What is the best way for the teacher and Risk Reduction Specialist to communicate?*

Phone

Email Address*

Phone Number*

Preferred classroom visit date*

We can visit each class on the same day (back-to-back) or come back on multiple days. Please list at least three date options between February 2024- May 2024 that work well for your classrooms.

Preferred Time Slots*

Questions, comments, or concerns regarding scheduling:

Send me a copy of my responses

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