Cutting Edge > Climate Change > Workshop 08 > Workshop Application

Teaching Climate Change with Ice Core Data

Workshop Application

Application deadline: April 1, 2008
The original application deadline has passed, but there are still spaces that may still be filled. Interested applicants are encouraged to apply.

Note that this application is only for the teaching workshop. For more information about the 2008 AMQUA bi-annual meeting, please visit the AMQUA website.

The On the Cutting Edge program funding for the operational costs of the workshop and meals for the participants. Participants are responsible for the travel and housing costs. Travel awards will be available by application.

If you are accepted for the workshop, you will be asked to complete a registration form to provide us with more information.

Complete the following form and click on SUBMIT to confirm your registration. Be sure to hit the SUBMIT button before leaving this page or your information will be lost. We encourage you to compose your answers to the longer questions in a word processor and to cut and paste the resulting text into this form. This gives you access to conveniences like spell checking as well as the opportunity to save and reflect on your work before submitting.

Contact Information
First Name:
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Last Name:
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Department:
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Institution:
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Address:
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City:
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Select a State:

Zip Code:
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Phone:
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FAX:
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Email Address:
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(Please Note: Your email address is what we use to track your application and participation in the workshop. Be sure to use the same email address in all forms relating to your workshop participation. This email will also be our primary means of communication with you.)

Question SetPlease provide a brief description of your teaching and/or research experience with ice core data.
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What might you be able to contribute to the workshop? What materials/programs/experience do you have that you would be willing to present at the workshop?
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Will you be willing to participate in follow-on activities (for example, working groups, theme sessions at professional meetings, creation of new educational materials, etc.)?
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What are your expectations for the workshop? In what ways do you hope you will benefit by attending this workshop?
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Poster SessionThe workshop will include a poster session and "share fair" to exchange ideas about teaching with ice core data. We strongly encourage everyone to present a poster.

If you would like to present a poster, please provide the (approximate) title.
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DemographicsGender:
Male

Female

Ethnicity (choose one):
Hispanic or Latino

Not Hispanic or Latino

Race (select one or more):
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White

Disability status (select one or more):
Hearing Impairment
Visual Impairment
Mobility/Orthopedic Impairment
Other
None

Citizenship (choose one):
U.S. Citizen

Permanent Resident

Other non-U.S. Citizen

Number of years of full-time teaching experience:
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Number of years teaching at the college level:
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Current position:
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Discipline:

or Other discipline:
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Will you teach next fall at an institution that serves a large number of minority students?:
Yes

No

Which of the following best describes the department or program in which you will teach next fall:
Two year college (Associate is the highest degree)

Private four-year primarily undergraduate (BS or BA is the highest degree)

Public four-year primarily undergraduate (BS or BA is the highest degree)

Masters granting (MS is the highest degree)

Doctoral granting (PhD is the highest degree)

Travel StipendsTravel stipends of $200 are available to the first 50 applicants who request them.

Are you interested in receiving a $200 travel stipend?

I do not require a stipend

Yes, I would like a travel stipend.
Please read the instructions below and provide information as needed.

Workshop stipends will be processed following completion of the workshop. Stipend recipients are required to attend the entire workshop through the last session. In order to process payment your social security number is needed. To protect personal information, we will ask you to provide your social security number to us by mail or over the phone after the workshop.

Your full name used for federal income tax information
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Your home (not work) address, matching the address used for federal income tax information
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How did you learn about this workshop?
e-mail announcement

mailed brochure

browsing the Internet

link from the DLESE web site

link from the NAGT web site

word of mouth

other

If there is other information relevant to your application, please let us know here:
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*Please type the two distorted words into the box below. Separate them with a space. This helps us prevent spam. For more details or help click the question mark.

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