Teaching STEM in HSIs Mini-Course Registration
This form indicates your commitment to attend the Teaching STEM in Hispanic Serving Institutions Mini-Course. Please enter the following information so that we can get to know you better. We will send you a confirmation email once we have processed your registration.

SUMMER SESSION: June 23-25, 2021. The course consist of live facilitated discussions on Zoom each day (Wed, Thursday and Friday) from 8:00 am-12:00 pm Pacific. The time block will be divided into two 90 min sessions with a 30 min break in between for getting coffee, eating lunch or running around your yard.

FALL SESSION: The fall course will be delivered on six consecutive Fridays, starting Sept 3, 2021 and ending Oct 8, 2021. Friday sessions will run 90 minutes, from 8:00 am-9:30 am Pacific.

Homework Exercises: To earn a Mini-Course Certificate you will have 5 exercises to complete outside of the sessions. The exercises are 5 written reflections that take approximately 1.5 hours to complete.

Waitlist: In order to keep the course as interactive as possible, each course will be limited to 30 participants. We will notify you by May 30 if there are any spaces available for the Summer session, and by Aug 20 for the Fall session.

Contact us at escalaeducation@gmail.com for questions or changes to your registration.
Email address *
1. First Name *
2. Last Name *
3. Cell Phone (we will text one reminder prior to event)
4. Your Institution Name (please use full name i.e., California State University Los Angeles) *
5. Please indicate which session you are registering to attend. If the session is full, we will contact you and ask if you'd like to be on a waitlist or enroll in another open session. *
Required
6. Who is funding your registration? If you are paying for yourself, please write in your own name. *
7. What is your STEM academic discipline? (ie, Math, Physics, Mechanical Engineering) *
8. Tell us something about yourself as an instructor. How long have you been teaching, how long at your current Hispanic Serving Institution, and what types of courses you teach. *
9. What is one thing you hope to gain from coming to this program?
10. Do you have any questions about this program or other things you'd like us to know?
11. Each of the six course sessions will have several small group discussions and sharing of ideas. Please inform us of any concerns you might have in interacting live on Zoom with a camera or microphone.
12. Cancellation Policy: This is a small program and seats are limited. Registration closes on May 30, 2021 and after that no changes may be made to your registration. No refunds will be issued to colleges if you cancel after May 30--instead your college must send another person in your place. Please contact your Title V director or other funding source at your institution if you must cancel, as well as our organization. *
Required
A copy of your responses will be emailed to the address you provided.
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