Teaching
Space Science Workshop for
Middle and
High School Teachers
Madison,
Wisconsin, August 11-15, 2003
Please e-mail this information, or print and send it to:
Office of
Space Science Education
Space Science
and Engineering Center
University
of Wisconsin-Madison
1225 West
Dayton Street, Madison, Wisconsin 53706
Fax: (608) 262-5974 by June 15, 2003
Call or e-mail Sanjay S. Limaye (608 262-9541, SanjayL@ssec.wisc.edu if you have any questions
Name:
Grade Level and Course(s) you will teach during 2003 - 2004 School Year:
Course previously taught, if different:
Science Courses
taken (undergraduate/graduate):
School Address:
School Telephone Number: School E-Mail (if used regularly):
Home Address:
Home Telephone
Number:
Home E-Mail:
I want to
participate in this workshop because:
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I believe the workshop will help me to achieve the following:
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I understand
that if I want Graduate Credit through University of Wisconsin-Madison,
I will need to register as a Special Student and pay the required tuition
fee ($175, subject to change). I agree to make every effort to participate
in all 1-day workshop events that will be scheduled during the September
2003 - April 2004 on dates to be chosen that are convenient for most if
not all participants. If I actively participate in the Teaching
Space Science Workshop and contribute towards its success, I understand
that I will be eligible for a graduated stipend (based on participation)
of up to $1,000 over a one year period.
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Signature
SS # (for Stipend) Date