Personal
Information
Name:
Address:
City:
State:
Zip:
Home
Phone:
E-mail:
School/Organization
Information
Name:
Address:
City:
State:
Zip:
Phone:
E-mail:
Ethnicity
(optional):
Best
way to contact you:
home email
work email
home phone
work phone
other
School
Demographics (you must complete this section to be eligible)
School
type:
public
private
after-school
rural
suburban
urban
Estimated
percentage of students who will be in your class who are:
receiving free lunch
minority members
females
Describe
the type and amount of science resources available at your
school:
Teacher
Background - Help us make a good match!
Please
briefly describe your educational background, including
any science-related studies.
Relevant
teaching experiences: Please include professional development
activities, curriculum development, in-service activities,
and collaborative projects.
Grades
and subjects you will be teaching next year.
Years
of teaching experience:
What
language(s) do you speak?
Astronomy-related
Experience
Have
you taught astronomy before?
yes
no
If
so, for how long?
Please
list any other astronomy or science activities in which
you are involved.
When
during the year do you plan to teach astronomy (approximate
months)?
Working
with Project ASTRO
Why
are you interested in working with Project ASTRO?
How
will you include astronomy in your curriculum in 2008-09?
as a unit
integrated during the year
both
other
Do
you have flexibility to teach astronomy at any time during
the year?
yes
no
If
no, please explain:
Have
you had experience with classroom volunteers?
yes
no
If
yes, please explain:
How
did you hear about Project ASTRO?
I agree to attend the August two-day workshop and understand
that if I am unable to attend, I will not be eligible to
participate in Project ASTRO. Astronomers and teachers are
required to commit to at least 4 classroom visits per academic
year. By checking the box above, I certify that the above
statements are true, and that I am able and willing to accommodate
such visits during the 2008-2009 academic year.
IMPORTANT:
Administrator support leads to more successful partnerships.
Please have the appropriate administrator in your school or
district, or Executive Director, certify support for your
participation in Project ASTRO by completing and signing the
administrator support
form . Unsigned applications will not be accepted.