Leaders Application

Personal Information

Gender

School Information

Home Information

Email


Professional Information

Are you currently a full-time classroom teacher?


List the science and math undergraduate and graduate courses, and professional development workshops you have taken.

Please indicate which of the math disciplines identified below in which you are proficient.

Briefly describe any science (or STEM) field experiences in which you have participated, such as internships in a science laboratory. Include where and when the experience occurred and its duration.

What to you expect to learn from the program, and how do you anticipate using this learning in the classroom?

Describe an example where a professional development experience impacted your teaching.

Which Institute, for your grade level, do you wish to attend during Summer 2016? Please note that the same Institute repeats in 2 locations, therefore you only select one Institute. Also, remember that you must commit to attend all 5 days of the Institute.

Identify the time period (specific months and number of weeks) during the 2016-2017 school year when you will teach the topic of the institute(s) you selected.


Signatures

Before your application can be considered complete, you will need to print out an application signature page that you and your principal must sign. In addition, you must also print out and sign a teacher consent form for assessments and evaluations. These forms may be emailed to Patricia.Slater@stevens.edu or faxed to 201-216-8069.

The forms may be found here.