Teacher Response Form   

NOTE: Fields marked in red are required. Thank you.

School Name:
Address:
Address 2:
City:       State:    Zip code:
Contact Name:
Telephone:       Email:

Grade(s): 

          
                     Number of students:    Time Spent:
 

Please Record which activities your class completed.

 
Level One Activity:

Please record the number of students who took THE GREEN TEAM pledge:  
 
Please check which Level 2 activities your class completed:
 
Climate Change Scorecard  Light Bulb Lesson and Energy Reduction Pledge
Slash Trash Report   Idling Reduction Pledge
Wrote letters or news articles Designed an energy-efficient vehicle
Created recycling signs & posters Researched energy-efficient automobiles
Used THE GREEN TEAM Library   "Give Your Car a Break-Trip Tally"
Other (Describe the activity):  Please describe the results:    
 
Please check which Level 3 activities your class completed:
 
Calculated carbon footprint at home or school Project to "green" school or community
Planted a tree or garden Helped protect rain forest or natural area
Waste free day Made school an Idle-Free Zone
Set up a classroom or outdoor compost bin
Built a prototype vehicle
Set up a school recycling program Created Safe Routes to Schools program
Held a school rummage sale or drive

Other (Describe the activity):       Please Describe the results:    
   

How did your class benefit from the activities? 

Will you participate in THE GREEN TEAM next year? 

      Yes             No

Additional Comments: 

If you have pictures, either hard copies or digital, please submit them for possible
inclusion in future GREEN TEAM newsletters, materials or on our web site.