GluckLive Fellows Request Form for Site Coordinators 2022-23
Site Coordinators, please submit one form per GluckLive Fellow requested.
List all teachers/hosts who would like this Fellow to come to their classes face-to-face at your school/site or on Google Meets. (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.)

To save travel time, 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.

Distance Learning requires screen sharing, and may require participants to have some basic classroom supplies (scissors, writing and materials, paper, glue, etc) Please read the requirements so your participants can fully participate in the activity. Specialized consumables will be dropped off at the office before the session date.

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.

SPECIAL REQUESTS - do you have an idea for a program? Describe it here and we will see if we have anyone to make a match!

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.edu to set up your site!
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이메일 *
GluckLive Fellow / Ensemble Requested *
one fellow per form, please
Name of School / Site *
Face-to-Face or GoogleMeets/video conferencing?
For ease of scheduling, please submit separate requests when requiring BOTH face-to-face AND video conferencing
선택해제
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 in class or on the Zoom room. Zoom 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. If you are requesting for future months, please let us know to help us plan the year.
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 class or Zoom room. (ex. Ms. Smith, Mr. Jones, Mr. Bojangles)
Notes for Scheduling
Include any information, Covid Protocols or special needs to help us schedule the Fellow, also your  (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, presentations will take place outside, masks required, fellow must show proof of vaccination.. etc.)
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