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First Name Last Name Work Email Address Job Title

Select a Job Title Superintendent Assistant Superintendent Chief Academic Officer Director of Curriculum and Instruction Elementary Curriculum Director Secondary Curriculum Director Principal Assessment Director Instructional Coach Instructional Technology Teacher Parent Student Other: District Administrator Other: School Administrator Other

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School/District Name What are your interest(s) in Khan Academy Districts?

Learning Paths informed by MAP Growth 3-8 Math 9-12 Math AP Courses Official SAT Practice Middle School Science High School Science Khan Kids (PreK-2 Math and ELA)

What is the student enrollment of your district?

Less than 250 students 250-999 students 1,000 - 2,500 students 2,500 - 9,999 students 10,000+ students

When are you thinking of piloting or implementing a new AI or Supplemental tool for your district?

Within the next year Within the next two years Not sure

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