Please provide the following information to create your new Imagineaction Profile. Your email address will be used as your username when logging into the System.

First Name: *
Last Name: *
Username (email): *
Password: *
Confirm Password: *

When setting your password, please provide at least 1 non-alphanumeric character. For example @, !, #, $...

Organization Information

Organization:
Address Line 1: *
Address Line 2:
City: *
Province: *
Postal Code: *
Country:
Work Phone: *
+1 ( ) -
Grade Levels: *

Please enter an alternate email if you prefer to receive correspondence to an address other than your login.

Alternate Email:

Expertise

Why would you like to become an Imagineaction community partner? (max. 350 characters) *

More info Themes *

Please provide your actual expertise in one or more selected themes. This is the description that will be searched by teachers who are looking for a partner. (max. 350 characters) *

Type characters in here: *
* required field