Are you available all 5 days of the institute? No Yes

Name

School Information

School Name

School District

Full School Address

Grades Taught Check all that apply.
K-2
3-5
6-8
Highschool

How long have you taught within each grade level?
K-2
3-5
6-8
Highschool

Does your school receive Title I funding? No Yes

Personal Information

Most of our communication occurs in summer months, so please provide contact information that will make it easy to reach you.

Full Home Address

Phone Number

Alternate Number

Email Address

Alternate Email Address

How did you hear about the program? Check all that apply.
Friend or Colleague
Open House at the Aquarium
Email from the district
Email from the Aquarium
Aquarium Website
Aquarium Facebook
Other

Getting to know you…

We’d like to get to know you as an individual and as a teacher.

1. Why do you want to participate in the 2012 Boeing Teacher Institute? What are you hoping to gain for your classroom, your students, or yourself?
100 words max

2. Tell us about the professional development experiences in which you have participated. What did you get from those opportunities? Feel free to include both good and bad experiences.
100 words max

On a scale of 1 -5 (with 1 being not at all comfortable and 5 being extremely comfortable), how comfortable are you with the following:

3. Locating marine science resources for educators in Southern California
1 - Not at all comfortable 2 3 4 5 - Extremely comfortable

4. Utilizing such marine science resources in your classroom
1 - Not at all comfortable 2 3 4 5 - Extremely comfortable

5. Being in the water (i.e. swimming, snorkeling)? Note: snorkeling experience is NOT a requirement in participation
1 - Not at all comfortable 2 3 4 5 - Extremely comfortable

On a scale of 1 -5 (with 1 being not at all familiar and 5 being extremely familiar), how familiar are you with the following:

6. Basic marine science content
1 - Not at all familiar 2 3 4 5 - Extremely familiar

7. Marine science research currently being conducted by scientists in the field?
1 - Not at all familiar 2 3 4 5 - Extremely familiar

On a scale of 1 -5 (with 1 being never and 5 being often), how often do you:

8. How often to do use hands-on science activities in your science lessons?
1 - Never 2 - Rarely (1-2/quarter) 3 - Sometimes (1-2/month) 4 - Regularly (1/week) 5 - Often (1+/week)

9. Integrate data into your classroom (i.e raw data, graphs, models or visualizations)?
1 - Never 2 - Rarely (1-2/quarter) 3 - Sometimes (1-2/month) 4 - Regularly (1/week) 5 - Often (1+/week)

10. Participation in an online professional development community will be required of all 2012 BTI participants. A closed group on Facebook will serve as our online forum to communicate, share resources, and continue to grow as a group. How do you see yourself staying involved, using this tool, and contributing to this community?
100 words max

Recommendation letter

Do you have a scanned electronic copy of your signed recommendation letter? You can upload it here as a PDF. Otherwise, you will need to mail or fax a copy after you submit this application electronically.