* Required

* 1. Surname:
e.g. Smith, García, Kowalski, Silva, Müller...

* 2. First Name:
e.g. Diana, Albert, Maria, Susanna, John, Laura...

* 3. E-mail address:
Please make sure you write your email address correctly

* 5. City where you teach:

* 6. Name of your school:
(If not teaching at the moment, please write: "n/a" and add the name of the organization where you work. E.g. "n/a science museum")

* 7. Postal address of your school:
Please write the full postal address of your school. For example:
European Schoolnet, Rue de Treves 61, 1040, Brussels, Belgium

* 8. Are you already part of the Scientix community?

* 9. Subjects you teach:
Please select all options applicable to you.

* 10. Age of your students:
Select all the relevant ages. If not teaching any longer, choose the ages of students you have taught in the past.

* 11. Have you read the full course handbook?

* 12. Will you be able to allocate the required time to complete the course? (The course will take approximately 55 hours of participant work.)

* 13. Please explain briefly why you wish to enroll in this course.

* 14. Terms and conditions (Make sure to read them very carefully)

  Yes No
I have written my name and surname fully and correctly.
I understand European Schoolnet will not enter into any discussion regarding the results of the selection of teachers to participate in the training.
I understand that to process my application, collection and storage of personal data (name, surname, email address) is necessary. Access to this information is strictly limited to EUN Partnership AISBL and will only be used for this specific purpose.
The work presented in this document is supported by the European Commission’s H2020 programme – project Scientix 3 (Grant agreement N. 730009), coordinated by European Schoolnet (EUN). The content of the document is the sole responsibility of the organizer and it does not represent the opinion of the European Commission (EC), and the EC is not responsible for any use that might be made of information contained.

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