8.31.2013

Name ______

Year-round mailing address ______

StreetCityStateZip

Preferred e-mail ______Preferred phone_(______)______-______

Area code

Your school ______

School address ______

StreetCityStateZip

Your principal’s name and title______

Current grade level(s) and/or course(s) you teach ______

If you are an elementary teacher, do you teach science? Yes No

Do you and your students have access to computers at school? Yes No

Does your school have high speed Internet access? Yes No

The following information will help to inform workshop plans, but your replies will not affect selection.

Rate your experience in leading instruction using probes, sensors, and/or computer models by placing an X on this continuum:

1______5______10

no experiencesome experience considerable experience

Would you be willing to share ITSI-SU workshop activities and resources in a presentation to colleagues in your school district and/or at a science conference such as KATS Kamp? Yes No

How many years have you taught science or math? ______What grade level(s)? ______

(application continued on p. 2; your signature is required on p. 2)
2013-14 ITSI PLC & Online Workshop Application, p. 2 Applicant: ______

Your signature below signifies that you are available and willing to complete all of these activities:

1.Attend one face-to-face workshop to kick off ITSI activities on Saturday, Sept. 28, 2013, 9 a.m. – 4 p.m. at the KU Edwards Campus.

2.Set up your classes in the ITSI portal (Learn how-to on Sept. 28);

3.Give your students online STEM pre- and post-surveys (one class period each; instructions in online courses)

4.Take online teacher inquiry surveys (pre- and post-; instructions in online courses); and an NSF survey

5.Give 2 pretests to your students; teach 2 ITSI exemplar activities to your students between November-March. Students complete post-tests after each activity. Activities and pre-post-tests will take 2-4 class periods for your students. (Learn how-to on Sept. 28)

6.Complete 2 online course activities:

  1. First course in October-November 2013 focuses on inquiry instruction using ITSI activites;
  2. Second course in February-March 2014 will include videotaping your students doing an ITSI activity (permission forms required), and will include building a video paper through online course instructions. Each online course will take approx. 8 hours of your time.

7.Show your Video Paper to colleagues to analyze instruction and learning (lesson study).

8.Participate in ITSI online PLC in Schoology from October – May (Learn how-to on Sept. 28).

Your signature ______

Teachers selected to participate will receive:

  • $400 stipend paid at the end of the school year upon completion of ALL activities listed above (FYI: no partial stipends).
  • $300 commercial probeware or other technology tools of your choosing.
  • Free research-based online tools and free open-source software to create and modify activities based on your own curriculum and objectives; activities accessible during and beyond 2013-14.
  • Online PLC connections with other teachers that last beyond the 2013-14 academic year.
  • Implementation and technical assistance.

Refer a colleague:Do you have a colleague who might be interested in the ITSI PLC and online workshop? If so, please provide that person’s name and contact information and forward this application to your colleague.

Colleague’s name ______

E-mail ______School ______

Applications must be received by September 14, 2013. Send application to: Carol Williamson

KU Center for STEM Learning

1000 Sunnyside, Suite 3078

Lawrence, KS 66045

785-864-8028

Email applications accepted: