Project ASTRO™ Astronomer Application Form
Click here for a pdf version of this form.
Fax (415) 337-5205 or send to Project ASTRO™ Applications, ASP 390 Ashton Ave., San Francisco, CA 94112
The 2006 Project ASTRO™ training workshop will take place in August 4-5, 2006 (Friday and Saturday). Participating teachers and astronomers are required to attend.
Return application by May 5, 2006.
Personal Information
Name __________________________________________________
Address _________________________________________
________________________________________________________
City _____________________________________________________
State _________________________________ Zip ____________
Home Phone _____________________________________
E-mail _____________________________________________
Ethnicity (optional) _____________________________________________
Professional Information
Employer______________________________________________
Your Position__________________________________________
Full-time or part-time? __________________________________________
City _____________________________________________________
State _________________________________ Zip ____________
Phone _____________________________________
E-mail _____________________________________________
Best way to contact you __ home e-mail __ work e-mail __ home phone __ work phone __ other
Astronomer Background - Help us make a good match!
Please briefly describe your educational background.
___________________________________________________________________________________________________
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Please briefly describe your background and your experiences in astronomy (if different).
___________________________________________________________________________________________________
___________________________________________________________________________________________________
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Experiences with Youth
Describe experiences you have working with schools or explaining astronomy to students and/or the public.
___________________________________________________________________________________________________
___________________________________________________________________________________________________
Please list any other experience you have working with children.___________________________________________________________________________________________________
___________________________________________________________________________________________________
What grade level(s) do you prefer to work with (circle all that apply) 4 5 6 7 8 9 no pref.
Would you be interested in working with a community-based organization (eg. Boys' & Girls' Club) or after-school program? ___ yes ___ no
Astronomer Interests and Affiliations
Why are you interested in working with Project ASTRO™?
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Please list astronomy organizations you are affiliated with and how long you have been involved.
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How can any of the organizations mentioned above contribute to your participation in the project? (e.g. Will your club put on a star party at your partner school?)
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What topics or areas of astronomy are of particular interest to you?
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Commitment
We ask that astronomers make at least four visits to their partner school or community organization, plus one planning/observation visit. Most visits will be during the school day. Please indicate times/days you are available:
| Time | Day | ||||
| ___ morning (8am-noon) | M | T | W | Th | F |
| ___ afternoon (noon-2pm) | M | T | W | Th | F |
| ___ after school (2pm-6pm) | M | T | W | Th | F |
| ___ evenings | M | T | W | Th | F |
| ___ weekends | Sat | Sun | |||
Preferred Location
We will make every effort to place you at a school that is convenient to you. Would you prefer to volunteer near to:
__ your home: list possible areas_____________________________________
___________________________________________________________________
__ your work: list possible areas_____________________________________
___________________________________________________________________
__ Either home or work
How far are you willing to travel?
________ miles from work _______ miles from home
How did you hear about Project ASTRO™? __________________________________________________________________
IMPORTANT: Some school districts require fingerprinting or a criminal background check for all non-parent volunteers. Are you willing to comply with your partner’s school policy for screening volunteers? ___ yes ___ no
Is there any reason you would not pass a screen? ___ yes ___ no
By signing this form, I certify that the above information is true and that I am able and willing to make the commitment of time and energy described above to Project ASTRO™.
Signature:_____________________________________________________________
Date:__________________________________
If you have any questions, call (415) 337-1100 x101, or e-mail bayareaastro {at} astrosociety.org.