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THURSDAYS 4:30 - 7:30 PM
218 HITCHCOCK HALL |
7 CLASSES:
JAN. 11, 18, 25, Feb. 1, 8, 15, March 1 |
| YOUR NAME | ||||
| HOME ADDRESS | ||||
| HOME PHONE | HOME EMAIL | |||
| SCHOOL NAME | ||||
| SCHOOL ADDRESS | ||||
| SCHOOL PHONE | SCHOOL EMAIL | |||
| GRADE LEVEL YOU TEACH | ||||
| NUMBER OF YEARS YOU HAVE BEEN TEACHING | ||||
| SUBJECTS YOU TEACH | ||||
| TOTAL NUMBER OF STUDENTS YOU TEACH | ||||
| ESTIMATE THE PERCENTAGE OF YOUR STUDENTS THAT ARE: | ||||
| African American | Hispanic | |||
| Native American | Pacific Islander | |||
| Caucasian | Other | |||
| Low Income | ||||
| PLEASE ANSWER THE FOLLOWING QUESTIONS | ||||
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1. What is your academic background in science?
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2. Describe your current science curriculum.
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3. What do you hope to achieve from your involvement in this institute?
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| All registration costs and materials for QUILS are provided by HHMI. | ||||