2018 BC-CZO Teacher Mountain Research Experience Program Application Form
This application is for participation in an NSF-funded teacher professional development workshop coordinated by the University of Colorado Boulder's Science Discovery Program, the CU Institute for Arctic and Alpine Research, and the Boulder Creek Critical Zone Observatory Program. All information provided will be kept in confidence and will not be shared or used for any other purposes including marketing, promotions, etc.
Will you be able to fully participate in the June 25th-27th 2018 workshop (12:00 PM Monday - 4:00 PM Wednesday) if you are accepted? *
Please fill in the space below with your full, legal name and middle initial for payment and class registration purposes *
Your answer
Please enter your full mailing address in the space below *
Your home/legal address with street, city, state and zip-code)
Your answer
School and District Name or Organization Name *
Your answer
School Address *
Street, city, state and zip code
Your answer
Daytime Phone Number *
Your answer
School/Business Email Address *
Your answer
Personal Email Address
Your answer
Are you currently a full-time middle or high school teacher? *
Grades Taught *
In this or the upcoming school year.
Your answer
Subject/Content Area(s) Taught *
Your answer
Do you currently hold a teaching certification? *
If you answered yes to the above, in what endorsement area(s) are certified to teach? *
Your answer
Will you teach earth or environmental science in the 2018-2019 school year? *
How many years have you been teaching? *
Your answer
What best describes the setting for your school? *
How many learners (K-12) do you expect to impact in the 2018-2019 school year? *
Your answer
What percentage of the potentially impacted learners come from groups underrepresented in STEM Fields *
For our purposes this includes all females and members of all ethnic groups other than Asia American and Caucasian
Please describe your motivation for participating in this field course. *
Your answer
How will this field-based experience benefit your students and/or impact your teaching practice? *
Your answer
Please describe ways you currently, or aspire to, use the outdoors/natural environment as an integrating context for STEM learning? *
Your answer
Have you ever hiked/walked in high elevations, over 8000'? If so, have you experienced any severe negative physiological impacts other than being out of breath (edema, mountain sickness, chest pain, severe/disabling cramps, light headed, etc.)?
Your answer
Please enter any other information that you feel would be beneficial to you in the application process in the space below.
Your answer
If all the information you have entered on this form is correct, and to the best of your knowledge accurate, please certify the application by entering your full, legal name in the space below. *
Your answer
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