September 30 EET Workshop Registration

Exploring Regional Differences in Climate Change

First Name:
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Last Name:
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Please enter your primary email address. The address you enter will serve as your unique identifier for workshop registration and payment purposes. Please use the same email address to identify yourself whenever you are prompted to supply it.

Email:
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Position:
Classroom Teacher

Staff Development Specialist working with grade 6 to 12 teachers

University faculty working with grade 6 to 12 teachers

Other

If Other, please describe:
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Select the grade range that best describes the students you teach:
Grades 6 to 8

Grades 9 to 12

Grades 13 or above

Select the subject area that best represents your primary teaching responsibilities:
Math

Technology

Life science

Physical science

Earth science

Chemical science

General science

Click the check boxes to indicate which subjects you are currently teaching. (Please check all that apply.)
Math
Technology
Earth Systems Science
General Science
Environmental Science
Biology
Space Science
Chemistry
Geology
Atmospheric Science
Ecology
Physics
Integrated Science
Oceanography
Geography

Approximate Number of Students Taught:
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School District:
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School Name:
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School Street Address:
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City:
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Select a State:

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

African American:
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Asian:
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Caucasian:
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Latino/Hispanic:
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Other (please describe):
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Estimate the percentage of students at your school for whom English is a second language:
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Estimate the percentage of students at your school that receive free/discounted lunch meal tickets:
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The platform of the computer you will use during the seminar:
Mac

PC

Other

If Other, please describe:
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Type of Internet connection you will access during the seminar:
Slow (dial-up)

Fast (DSL; cable)

Do you have access to Internet connected computers in your classroom?
Yes

No

Do you have access to Internet connected computers in a computer lab that you can use with students at your school?
Yes

No

What type of Internet connection do you have available at school?
Slow (dial-up)

Fast (DSL; cable)

How did you hear about this opportunity?
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Would you like to be notified of other EET opportunities such as future teleconference online workshops?
Yes. Please keep me informed of other EET opportunities.

No thank you. Please do not inform me of other EET opportunities.