PRE-REGISTRATION REQUEST FORM

School and science museum:

Cooperation for improving teaching, learning and discovery

European in-service training course for teachers and museum educators

X EDITION, 17-22 FEBRUARY 2014, DE-2014-1388-001

Deutsches Museum Munich

The request for funding to the Socrates National Agency should be accompanied by the confirmation of pre-registration to the training course. The confirmation will be sent to the candidate by the National Museum of Science and Technology Leonardo da Vinci after receiving and evaluating the information included in the pre-registration form.

In order to pre-register to the training course, please fill in the following form and send it to Erica Locatelli:

Erica Locatelli

Museo Nazionale della Scienza e della Tecnologia Leonardo da Vinci

Servizi Educativi | Via San Vittore 21 | 20123 Milano |

T +39 02 48 555 384 |

PERSONAL DETAILS

Name

Surname
Title
Date of birth
Position/Occupation
Name of institution
Type of institution:
School, Museum,
Other (specify)
For school – grade: primary, secondary,
other (specify)
For museums:
Natural history
Science and Technology Science centre
Other: specify
Address
Zip code and city
Nation
Telephone number
Email address

In case the number of requests for participation to the course exceed the number of posts available, the following information could be used for the selection of the participants.

a. How many years did you work in a school/museum?

b. What type of activities do you carry out?

c. Why do you want to attend the course: (not more than 50 words)

d. Did you participate to Comenius/Grundtvig training courses before?

£ Yes £ No

If yes, when?

e. How did you get to know about the course?

f. Additional comments/information

For details regarding grants for covering the expenses and participation procedures contact the National Agency of your own country. Information about the National Agencies can be found at:

http://ec.europa.eu/education/lifelong-learning-programme/doc1208_en.htm

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