Middle School Aerospace Scholars (MAS) Application
[June13-18, 2004 and June 20-25, 2004]
4 Member Teams

Application Deadline
March 12, 2004

Instructions: Complete the team application below. Information is required for each team member, along with an accurate e-mail address for your Principal. This form may be printed and completed by team members before the online application is submitted. All applications must be submitted electronically.

Once your team application has been submitted online, an email message will be automatically sent to your Principal, requesting them to submit a letter of recommendation and a letter of support for your team electronically. Your application will not be officially complete until (1) your team's application is submitted online, and (2) your Principal's recommendation and letter of support has been submitted. Please follow up with your Principal and emphasize the importance of sending this supporting information electronically.

Thanks for applying to the MAS Program!


Our School Team would like to attend the following MAS Program:
June 13-18, 2004 OR
June 20-25, 2004
School Information
School Name    
School Address
City State Zip

County

School Phone School Fax

School District

Educational Service Center No. - Region

Principal's Name
Principal's E-mail

School Type (Choose one from each row)
    Public Private
    Urban Suburban Rural

Current School Year Ends: Month Day Year 2004

Distance Learning Capabilities in School:
Videoconferencing Connection (Ask your technology contact) H.320/dial up H.323
Internet Connection Yes No

Name of technology instructor/technician in your school
Applicant I Information
Applicant's Name
Social Security No.
U.S. Citizen? Yes No

Home Address
City     State Zip
Phone Home Fax

School E-mail
Personal E-mail

Current Position/Title (Mark all that apply):
Teacher Administrator Technology Instructor Media Specialist Resource Teacher Curriculum Specialist
Other
Grade(s) you currently teach
Subject(s) you currently teach
Number of class periods you teach
and average number of students in each class

Degree(s) Received

Previous Teaching Experience(s):
I. Previous Teaching Position: II. Previous Teaching Position:
Year (eg. 1996-1997) Year
District District
School School
Grade Level Grade Level
Subject Subject
 
III. Previous Teaching Position: IV. Previous Teaching Position:
Year Year
District District
School School
Grade Level Grade Level
Subject Subject

Technology Information

Technology available in your school (Mark all that apply):
Computers with internet connection
Computers without internet connection
Digital Cameras
 Hand-held computers
Graphing calculators
Other - please list

How are students currently using technology in your school?
Internet Research
PowerPoint Presentations
Virtual Field Trips
Online Assignments
Word Processing
Other - Please explain


Rate Your Computer Experience (select one):
Basic Skills (getting started, able to use a few programs, i.e. word processing and email)
Intermediate Skills (proficient in the use of several productivity programs, such as Powerpoint, Excel, etc.)
Advanced Skills (uses technology to create web pages, develop multimedia, design instructional environments)

What is the computer/student ratio in your classroom and/or lab? (Example: 2/1)

How did you find out about Middle School Aerospace Scholars?
Mail Out/Brochure Web Site
Conference (If conference, which one? )
Other (explain: )

Professional Organizations/Activities:
(research interests, in-service participation, membership in organizations, and publications)

Educational conferences you have attended within the last three years:

Describe the innovative and motivational approaches you use to address the educational needs of your students (you may cut and paste your response from a word or notepad document, please keep responses to 75 words or less):

Completion of the following information is voluntary. This information is used to determine the teacher populations being served by this program.

Gender: Male Female
Individual with a Disability? Yes No

Race:
African American Hispanic Asian American Caucasian
Native American Pacific Islander Other

Applicant II Information
Applicant's Name
Social Security No.
US Citizen? Yes No

Home Address
City     State Zip
Phone Home Fax

School E-mail
Personal E-mail

Current Position/Title (Mark all that apply):
Teacher Administrator Technology Instructor Media Specialist Resource Teacher Curriculum Specialist
Other
Grade(s) you currently teach
Subject(s) you currently teach
Number of class periods you teach
and average number of students in each class

Degree(s) Received

Previous Teaching Experience(s):
I. Previous Teaching Position: II. Previous Teaching Position:
Year (eg. 1996-1997) Year
District District
School School
Grade Level Grade Level
Subject Subject
 
III. Previous Teaching Position: IV. Previous Teaching Position:
Year Year
District District
School School
Grade Level Grade Level
Subject Subject

Technology Information

Technology available in your school (Mark all that apply):
Computers with internet connection
Computers without internet connection
Digital Cameras
 Hand-held computers
Graphing calculators
Other - please list

How are students currently using technology in your school?
Internet Research
PowerPoint Presentations
Virtual Field Trips
Online Assignments
Word Processing
Other - Please explain

Rate Your Computer Experience (select one):
Basic Skills (getting started, able to use a few programs, i.e. word processing and email)
Intermediate Skills (proficient in the use of several productivity programs, such as Powerpoint, Excel, etc.)
Advanced Skills (uses technology to create web pages, develop multimedia, design instructional environments)

What is the computer/student ratio in your classroom and/or lab? (Example: 2/1)

How did you find out about Middle School Aerospace Scholars?
Mail Out/Brochure Web Site
Conference (If conference, which one? )
Other (explain: )

Professional Organizations/Activities:
(research interests, in-service participation, membership in organizations, and publications)

Educational conferences you have attended within the last three years:

Describe the innovative and motivational approaches you use to address the educational needs of your students (you may cut and paste your response from a word or notepad document, please keep responses to 75 words or less):

Completion of the following information is voluntary. This information is used to determine the teacher populations being served by this program.

Gender: Male Female
Individual with a Disability? Yes No

Race:
African American Hispanic Asian American Caucasian
Native American Pacific Islander Other

Applicant III Information
Applicant's Name
Social Security No.
U.S. Citizen? Yes No

Home Address
City     State Zip
Phone Home Fax

School E-mail
Personal E-mail

Current Position/Title (Mark all that apply):
Teacher Administrator Technology Instructor Media Specialist Resource Teacher Curriculum Specialist
Other
Grade(s) you currently teach
Subject(s) you currently teach
Number of class periods you teach
and average number of students in each class

Degree(s) Received

Previous Teaching Experience(s):
I. Previous Teaching Position: II. Previous Teaching Position:
Year (eg. 1996-1997) Year
District District
School School
Grade Level Grade Level
Subject Subject
 
III. Previous Teaching Position: IV. Previous Teaching Position:
Year Year
District District
School School
Grade Level Grade Level
Subject Subject

Technology Information

Technology available in your school (Mark all that apply):
Computers with internet connection
Computers without internet connection
Digital Cameras
 Hand-held computers
Graphing calculators
Other - please list

How are students currently using technology in your school?
Internet Research
PowerPoint Presentations
Virtual Field Trips
Online Assignments
Word Processing
Other - Please explain


Rate Your Computer Experience (select one):
Basic Skills (getting started, able to use a few programs, i.e. word processing and email)
Intermediate Skills (proficient in the use of several productivity programs, such as Powerpoint, Excel, etc.)
Advanced Skills (uses technology to create web pages, develop multimedia, design instructional environments)

What is the computer/student ratio in your classroom and/or lab? (Example: 2/1)

How did you find out about Middle School Aerospace Scholars?
Mail Out/Brochure Web Site
Conference (If conference, which one? )
Other (explain: )

Professional Organizations/Activities:
(research interests, in-service participation, membership in organizations, and publications)

Educational conferences you have attended within the last three years:

Describe the innovative and motivational approaches you use to address the educational needs of your students (you may cut and paste your response from a word or notepad document, please keep responses to 75 words or less):

Completion of the following information is voluntary. This information is used to determine the teacher populations being served by this program.

Gender: Male Female
Individual with a Disability? Yes No

Race:
African American Hispanic Asian American Caucasian
Native American Pacific Islander Other

Applicant IV Information
Applicant's Name
Social Security No.
US Citizen? Yes No

Home Address
City     State Zip
Phone Home Fax

School E-mail
Personal E-mail

Current Position/Title (Mark all that apply):
Teacher Administrator Technology Instructor Media Specialist Resource Teacher Curriculum Specialist
Other
Grade(s) you currently teach
Subject(s) you currently teach
Number of class periods you teach
and average number of students in each class

Degree(s) Received

Previous Teaching Experience(s):
I. Previous Teaching Position: II. Previous Teaching Position:
Year (eg. 1996-1997) Year
District District
School School
Grade Level Grade Level
Subject Subject
 
III. Previous Teaching Position: IV. Previous Teaching Position:
Year Year
District District
School School
Grade Level Grade Level
Subject Subject

Technology Information

Technology available in your school (Mark all that apply):
Computers with internet connection
Computers without internet connection
Digital Cameras
 Hand-held computers
Graphing calculators
Other - please list

How are students currently using technology in your school?
Internet Research
PowerPoint Presentations
Virtual Field Trips
Online Assignments
Word Processing
Other - Please explain

Rate Your Computer Experience (select one):
Basic Skills (getting started, able to use a few programs, i.e. word processing and email)
Intermediate Skills (proficient in the use of several productivity programs, such as Powerpoint, Excel, etc.)
Advanced Skills (uses technology to create web pages, develop multimedia, design instructional environments)

What is the computer/student ratio in your classroom and/or lab? (Example: 2/1)

How did you find out about Middle School Aerospace Scholars?
Mail Out/Brochure Web Site
Conference (If conference, which one? )
Other (explain: )

Professional Organizations/Activities:
(research interests, in-service participation, membership in organizations, and publications)

Educational conferences you have attended within the last three years:

Describe the innovative and motivational approaches you use to address the educational needs of your students (you may cut and paste your response from a word or notepad document, please keep responses to 75 words or less):

Completion of the following information is voluntary. This information is used to determine the teacher populations being served by this program.

Gender: Male Female
Individual with a Disability? Yes No

Race:
African American Hispanic Asian American Caucasian
Native American Pacific Islander Other

 

Send questions or problems with this form to scholars@aerospacescholars.tamu.edu.