2017 Teachers on the Estuary: ACE Basin Coastal Exploration

Teacher Workshop Application

Applications are due by May 20, 2017. If you are accepted to participate in the workshop, you will be notified by May 25, 2017. Open to all 5th-12th grade teachers and nonformal educators.
Requirements: Commitment to three-day workshop, plus pre-webinar and post follow-up. MUST be able tolerate summer temperatures, insects, and physical activity. Upon completion of the workshop, teachers must provide a brief report on how lesson plans were incorporated into their curriculum throughout the year. All workshop participants are asked to bring one of the following: laptop or tablet that can be used to access the internet (WiFi provided).

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* 1. First Name

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* 2. Last Name

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* 3. I am a:

Male

Female

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* 4. Home Address:

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* 5. City:

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* 6. State:

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* 7. Zip Code:

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* 8. Cell Phone:

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* 9. Home Phone:

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* 10. Email: (that you access in the summer)

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* 11. School Name or place of work:

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* 12. School District:

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* 13. Work Address:

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* 14. City:

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* 15. State:

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* 16. Zip Code:

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* 17. Work Phone:

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* 18. Which grade(s) do you teach?

Other (please specify)

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* 19. How many students will you teach in the upcoming school year?

I do not know at this time.

Number of Students:

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* 20. What subject(s) do you teach?

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* 21. How many years have you been teaching?

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* 22. How did you learn about this course?

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* 23. My students have access to a computer with internet: (choose all that apply)

at home

at school, one computer on whiteboard in front of class

at school, each student (or group of students) has their own computer

at school, each student (or group of students) has tablet

Other (please specify)

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* 24. Please indicate any special needs or medical conditions you may have:

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* 25. Do you prefer vegetarian meals?

Yes

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* 26. Indicate food allergies:

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* 27. Why do you want to participate in this course?

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* 28. If you are selected, how will you use the information learned in your classroom?

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* 29. What other workshops, courses, or trainings have you participated in the last two years?