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State Seal of Civic Engagement Educator Interest Form

Teachers, counselors, instructional coaches, and administrators interested in bringing the California State Seal of Civic Engagement (SSCE) program to their students - please complete the form below to request curriculum access, implementation guidance, or an informational briefing.

Section 1: Educator and Site Information

Contact Name

Role/Title

School Site Name

District Name

Email Address

Phone Number

Target Grade Level(s)

11th Grade

12th Grade

Other

Section 2: Program and Student Need Overview

Please provide the following details regarding your current civic engagement efforts and intended participation.

Estimated number of participating students:

1-25

26-100

100+

School-wide

Target Implementation Timeframe

Fall Semester

Spring Semester

Full School Year

Date

Section 3: Specific Questions and Next Steps

Please list any specific questions regarding implementation, student eligibility, or logistics.