ASMSA COMPUTER SCIENCE PLUS CLASSES '17-'18
Please complete the form below to register for CS I & II classes for school year 2017-2018. There is no student tuition. There is a nominal $500 fee per class per year to help cover our expenses for workshops and ongoing support of teacher throughout the school year.

Space for these exciting programs is limited. For additional information please contact:

David Slaymaker, Assitant Dean for Outreach
501-622-5434/slaymakerd@asmsa.org

Daniel Moix, ASMSA Computer Science Education Specialist
501-622-5168/moixd@asmsa.org

Participating Teacher Contact Information
I am completing this form for: *
Title *
First name *
Your answer
Last name *
Your answer
Phone number
The best number to reach you to discuss this program
Your answer
School email address *
Your answer
Home email address
Your answer
School & District Information
School district *
Your answer
School name *
Your answer
Principal name *
Your answer
Principal phone
Your answer
Principal email *
Your answer
Describe the level of ability the teacher you will assign to this class has in in Computer Science.
Your answer
Assigned teacher licenses & endorsements
Your answer
Estimated number of students who would be participating from your school?
Your answer
District & Teacher Obligations
Teacher Boot Camp *
I understand the selected teacher is expected to attend a week-long boot camp at ASMSA July 23 - 28
On-Site Teacher *
I understand that the selected teacher will be co-teaching the class with the ASMSA remote teacher
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