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Application Form

Eyes in the Sky Professional Development Program
2006-2007

To apply for the Eyes in the Sky program, complete and submit this online application form.

The deadline for applying has been extended to November 30, 2005! Applicants will be notified of their status by December 2, 2005.

Personal Information:
First Name: Last Name:
Address:
Address 2:
(Apartment, suite, unit, building, floor, etc.)
City: State:
Zip:
Phone:
Email:

To help us determine the degree to which different segments of the population apply to this program, please check the items below that describe you. (Completion of this question is voluntary: applicants will be selected for participation based on merit, regardless of gender, race, religion, or national origin.)

Gender:

Female: Male

Race:

African
American:		 Asian: Caucasian: Hispanic: Native
American:		 Other:

If other, please describe:
List languages in which you speak or write fluently:

 

School Information:
School Name:
School Address:
Address 2:
(Unit, building, floor, etc.)
City: State:
Zip:
Phone: Fax:
School Email:
What is the best method for contacting you?
Home Email School Email Home Phone School Phone

If by phone, please include the best times to reach you.

 

Professional Preparation:
Undergraduate Institution:
School Name:
City/State:
Undergraduate major(s):
Graduate Institution:
School Name(s):
City/State:
Degrees(s):
Grad Major(s):

 

Science Teaching:

Click to indicate which courses you are currently teaching or have taught in the past.
  Currently Teaching Taught Previously

General Science

Physical Science

Earth Science

Chemistry

Physics

Astronomy

Technology

Engineering

Mathematics

Other

If other, please list:
Grade(s) Taught:
Total Years Teaching:
Approximately how often do you use the following resources or materials in your teaching?
  Daily Once
a week		 Once
a month		 Once
a year		 Never

Internet

CD-ROMs

Spreadsheets

Probeware

Maps

Textbooks

Laboratory Equipment

Supplemental Curricula

Activities you created

Library/Media Center
 
Rate your experience in each of the following areas:
  None Some Competent Skilled

Participating in Distance Learning Courses

Using Image Processing software

Using Global Positioning System (GPS) technology

Using Geographic Information System (GIS) software

Conducting Scientific or Educational Research

Facilitating Student Research Projects

 
Recall one or more science education workshops or courses in which you participated in the last five years. Describe the best one, including how and why it influenced your teaching.

 

Technology Access:

A central component of the Eyes in the Sky program involves teachers and students using information technologies in their schools, and as part of their classroom instruction. It is essential that both you and your students have ready access to adequate computer facilities. It is also essential that you have ample access to an internet-connected personal computer at home or school for your use during the distance-learning course.
How many computers do you have in your classroom?

Macs

PCs

Other
Of those computers, how many are connected to the Internet?

Macs

PCs

Other
How many computers can you access in a computer lab?

Macs

PCs

Other
Of those computers, how many are connected to the Internet?

Macs

PCs

Other
If you have access to a computer lab, approximately how often can your students use it?

Everyday

Several times
per week

Once a week

A few times
per month

Almost never
What type of computer do you have for personal use?

Mac

PC

Other
What type of Internet connection does this computer have?

Dial-up
modem

Cable
Modem

DSL

ISDN

T1 Line

 

Students at your school:
Estimate the approximate percentages of the student population at your school in the following categories:

African American:

Asian:

Caucasian:

Hispanic:

Native American:

Other: (please describe)
Estimate the percentage of students at your school for whom English is a second language:
Write two or three paragraphs describing why you should be selected for this program. Tell us what you expect to gain from participating, how you envision making use of this experience, and what strengths you would bring as an agent for introducing information technology skills and authentic research projects to students in your classes.
How did you first learn about the Eyes in the Sky program?

Presentation

Flyer

Listserve

Web site

Newsletter

Course Listing

Word of mouth

Other
Please provide any additional information you would like us to consider as part of your application:

 

Eyes in the Sky is an Information Technology Experiences for Students and Teachers Program, created and administered by TERC Inc. under cooperative agreement with the National Science Foundation. Support for the program is provided in part by ESRI, Inc.

 
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