EmailMe Form - 2013 Kids' College Session Proposal

Contact Information

Name *

First Last

Address *

Street Address City State / Province / Region Postal / Zip Code Country

Email *

Primary Phone Number *

### - ### - ####

Alternate Phone Number

### - ### - ####

Session Information

Please provide us with information on the session you are proposing.

Session Title (catchy and kid-friendly): *

Previous Instructors:

I instructed this session during the 2012 STEM Kids College and want to keep the session description the same. (We will email the description to you prior to printing for your review.)

Session Description (kid-friendly):

Dates/Time you want to offer your session (check all that apply): *

Morning

Afternoon

Both Morning and Afternoon

Morning session is from 9:00 am to 12:00 pm
Afternoon session is from 1:00 pm to 4:00 pm

Grade level of the children in the session: *

First - Third Grades

Fourth - Sixth Grades

Seventh - Eighth Grades

Only one grade level will be assigned to each session. Check each grade level that your session is appropriate for and we will assign a grade level to your session. Children will be entering this grade level in Fall of 2012.

Will your session require any special equipment/space? (check all that apply)

Will your session require a SFU Student Assistant?

No, I do not need a student assistant

Yes, I will occassionally need a student assistant (designate days on lesson plan)

Yes, I will need a student assistant for the entire session

Comments:

In addition to the information above, please attach your resume to this form or e-mail to scienceoutreach@francis.edu (be sure to include any work experience directly related to the course you will teach). Once your session has been approved you will receive an email with instructions on submitting a copy of your clearances and University paperwork.

Upload resume or email to scienceoutreach@francis.edu

If my session is approved, I agree to submit copies of the required clearances, all necessary university paperwork, and a lesson plan. *

Yes, I agree.