1. LA-SiGMA RET 2015 - Online Application

This page is an application form for the 2015 LA-SiGMA Research Experiences for Teachers.

This application MUST be completed and all required paperwork (essay, transcripts, and recommendation letter) MUST be turned in no later than March 8, 2015.

A (*) means the information is required.

* 1. Personal Information

* 2. School Information

* 3. Please tell us which one you are:

* 4. My state of residency is: (Full name OR official two letter abbreviation is fine.)

* 5. Gender

* 7. Do you have a documented disability?

* 8. Highest degree earned

* 9. Highest teaching degree level

* 10. Education Level of parents: Please mark the highest level attained for each parent.

  Elementary High School Some College Bachelor's Graduate/Professional Degree N/A

* 11. Certification Status

* 12. Areas of Certification

* 13. School System

* 14. School Type

* 15. My School is

* 16. Please describe the demographics of your school and you specific students.

* 17. Years teaching in a classroom

* 18. Grades Taught

* 19. Courses Taught

* 20. Academic Awards/Honors

* 21. Please describe any programming and lab experience you might have.

* 22. List the honorary and professional societies of which you are a member, indicating offices you hold, as well as any extracurricular activities/organizations in which you participate.

* 23. Have you attended any Educational Programs for Professional Development?

* 24. Have you participated in previous summer research programs?

* 25. Have you participated in a science or mathematics inservice project? If so, what was its name and who sponsored it (e.g., Regional Service Center, College/University, etc.)?

* 26. Please indicate the three or more general areas you are most interested in:

* 27. This application is for three LA-SiGMA RET programs in Louisiana: Louisiana Tech University (LA Tech), Louisiana State University (LSU), and University of New Orleans (UNO). You have the option of participating in the program of one of these universities. Please list them in the order of your preference.

  First Second Third No Preference Not here
LA Tech

* 28. If selected, will you need a parking permit for a car?

* 29. If selected, will you need on-campus housing?

* 30. Do you contribute to the Teachers Retirement System of Louisiana (TRSL)?

* 31. Please enter the contact information of your current principal or head of school who will submitting a support letter on your behalf. We will contact him/her via e-mail, therefore, it is important to provide a valid e-mail address.

* 32. How did you hear about this RET?

Remember this application and all required materials (essay, transcripts, recommendation letter) should be turned in by March 8, 2015 for you to be considered for the RET.

All materials, essay and transcripts, MUST be sent to:

Lindsay Gouedy
LA-SiGMA Outreach Coordinator
Either by e-mail:
lgouedy -at- latech.edu, e-mail subject: LA-SiGMA RET Applications,
or mail:
LA-SiGMA - LA Tech University
P.O. Box 10198 T.S.
Reese Hall Rm 125
Ruston, LA 71272
or fax:
Fax: 318-257-2562, Attn. Lindsay Gouedy

* 33. I certify that all the information given on this application form is accurate and true.