Summer 2021 Wide-Open Town Workshop Application Form
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Email *
Please check yes if you are interested in receiving occasional emails from the NEH about grant or study opportunities
Title
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First name *
Middle name
Last name *
Home address *
Home city *
Home state *
Home zip code *
Primary phone number *
School or institution name *
School or institution address *
School or institution city *
School or institution state *
School or institution zip code *
Please enter citizenship. If not US, please specify country of origin and month and year US residence began. *
Have you previously participated in an NEH-funded summer program? *
If no, enter N/A. If yes, please list the dates and titles of previously attended NEH Seminars, Institutes, or Workshops. *
How did you learn about this workshop? *
Required
How would you classify your institution? (check all that apply) *
Required
Subjects taught this year *
Grade levels taught this year *
Number of students taught this year *
Years of teaching experience *
Position (check all that apply) *
Required
Please rank your preferred dates of attendance for the workshop *
First Choice
Second Choice
Cannot Attend
June 20-25
July 18-23
Please let us know if you applied last year *
A copy of your responses will be emailed to the address you provided.
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