Teachers Guide - Operation Respect

Don’t Laugh at Me Registration Form
Name: _______________________________________________
Email Address: ________________________________________
Position: _____________________________________________
School Name: _________________________________________
School Address: _______________________________________
School District: ________________________________________
Grade Level(s) Taught: _________________________________
Subjects Taught:
❏ General
❏ Other (please specify) __________________________________________________
Have you implemented programs or curricula in social and emotional learning or character
education before (including conflict resolution, cooperative learning, diversity education,
intergroup relations, etc.)?
❏ Yes (please specify program type and number of years)
❏ No
Have you received professional development in the implementation of social and
emotional learning or character education before?
❏ Yes
❏ No
If you answered “No” to the prior question, do you feel that in spite of the fact that you do
not have formal professional development education in these areas that other experience
has prepared you to teach Don’t Laugh at Me?
❏ Yes (please specify related education or experience)
________________________________________________________________________
❏ No
Please mail your completed registration form to:
Don’t Laugh at Me
2 Penn Plaza
23rd Floor
New York, NY 10121
All information provided will be kept confidential and private and used solely for program
purposes by the offices of Operation Respect/Don’t Laugh At Me.
Introduction © 2000 Operation Respect, Inc. and Educators for Social Responsibility 13