Please note this form is intended for teachers who have completed their TIME Fellowship. If you wish to apply for the program, please visit www.barancikfoundation.org/TIME

* Denotes required fields

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* 1. First Name

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* 2. Last Name

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* 3. School

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* 4. Email

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* 5. Phone

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* 6. Project Summary

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* 7. Financial Report

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* 8. Creative Project Documentation - Please include any links to your project documentation. Videos and photo albums must be shared through a file-sharing service, such as Vimeo or Dropbox.

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* 9. Optional - Upload any other relevant documents

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* 10. How do you think your experience will affect your pedagogical approach?

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* 11. How do you think this personal experience will translate into your professional work?

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* 12. What is the best way to let other teachers know about the TIME Fellowship opportunity? Pick all that apply.

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* 13. Optional - Please share any additional comments or thoughts about your fellowship.

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