Gluck Fellows Request Form for Site Coordinators 2020-21

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Site Coordinators, please submit one form per Fellow requested.
List all teachers/hosts who would like this Fellow to come to their classes at your school/site. (Separate requests for the same Fellow from multiple teachers/hosts at a school will not be scheduled as quickly as a complete single request listing all teachers interested.)

Requests for several back-to-back sessions on one day for multiple classes have higher priority than requests for a single session. Confirmation of Fellow presentations and all questions will go through the established Gluck Site Coordinator.
Register your interest for a Fellow with this form, let us know the possible dates/days and times and we will contact you when the Fellow is available.

Are you NEW to Gluck? Please contact the Gluck Office to set up your site - all sites must be free and open to the public, and located within 20 minutes drive of UCR. We serve all public schools in these school districts: AUSD, JUSD, MVUSD, RUSD, VVUSD. Email us at gluckprogram.ucr@gmail.com to set up your site!

Email *

Fellow / Ensemble Requested *

one fellow per form, please

Name of School / Site *

Grade level(s) or Age Group Requested *

If you are not a school, please let us know if it is Family Learning or adults, etc...

How many participants / audience expected? *

Please tell us approximately how many people the fellow will see on the Zoom room. Fellows need access to screen sharing and chat feature.

How Many Sessions Requested? *

If we could fulfill your request completely, how many sessions would you like?

Dates / Days of Week Requested? *

List as many dates/days as possible to increase chances for scheduling (e.g. 'any Monday in October' or 'MWF except: ...') If Fellow has not yet provided their availability, we will contact you directly when available dates are known.

Times Possible? *

List as many times as possible, or a range, to increase chances for scheduling. Please let us know about recess and lunch times!

Names of Teachers / Hosts Requesting the Fellow *

Please give the names of the teachers or hosts who would host the Fellow in their Zoom room. (ex. Ms. Smith, Mr. Jones, Mr. Bojangles)

Notes for Scheduling

Include any information or special needs to help us schedule the Fellow (ex. SDC; 1st class will have recess in the middle; can use MPR; no projector in room, must finish by noon, 3 in one day)

A copy of your responses will be emailed to the address you provided.

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