Wayne Adult Ed Staff Inventory Survey

Call us:
317.988.7975
Classes in Marion, Hendricks,
& Morgan Counties

We want to know more about YOU!

Here at Wayne Adult Ed, we value our staff members and the unique talents YOU bring to our organization. Please fill out the survey below so that we may know more about you. All information will be shared only within our organization, unless otherwise noted. Share as much or as little as you are comfortable sharing!

We look forward to learning more about you!

Name*
First Last
I prefer to be called:
First
Address*
Street Address City State ZIP Code
I was born in:*
City State / Province / Region Country
Phone (personal)*
My personal phone number can be shared with:*
- Staff
- Students
- Public
Check ALL that apply.
School Phone Number (if applicable)
Birthday (Month and Day - year doesn't matter.)
Personal Email
School Email*
Spouse/Partner's Name (if applicable)
First Last
Spouse/Partner's Phone Number (if applicable)
Emergency Contact (if NOT spouse/partner)
First Last
Emergency Contact's Phone Number (if NOT spouse/partner)
Check the box that applies to you:*
- Wayne Adult Ed is my only job.
- I have another job in addition to my job at Wayne Adult Ed.
Other job(s) I hold in addition to Wayne Adult Ed:
Degrees that I hold: (Check ALL that apply.)*
- HSE/Diploma
- Industry Certification
- Bachelor's Degree
- Master's Degree
List ALL of the credentials (certifications, licenses - both teaching and other licensure-, endorsements, degrees, etc) that you hold:
List all professional organizations (IAACE, COABE, ISTA, etc) to which you belong. (List with commas between and do not press enter!)
List all civic and personal engagements (church, organizations, sports, clubs, fraternities/sororities, etc) to which you belong. (List with commas between and do not press enter!)
Please upload a photo of yourself. This will be used for our staff directory.