University of Alabama, Birmingham NCTA Seminar Application Form

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Thank you for your interest in this National Consortium for Teaching About Asia Seminar. This seminar is currently open to educators from Alabama, Delaware, Illinois, Kentucky, Louisiana, Minnesota South Carolina, and the southern counties of West Virginia.
Please complete the form below.

Registration Deadline: September 23, 2020
Seminar Leader: Dr. Will Womack
If you have any questions, please contact Dr. Womack at: will.b.womack@gmail.com

Last Name *

First Name *

Home Street Address *

City *

State *

Zip Code *

Your Phone Number *

Permanent Email Address *

Your Email Address at your School/institution (if different than your permanent email address)

School District in which you teach (if you are in a private school or other type of institution, put "N/A") *

School/Institution Name *

School/Institution Street Address *

School/Institution City *

School/Institution State *

School/Institution Zip Code *

School/Institution Phone Number *

Type of School *

Public

Private

Charter

Other:

Subjects and Grade Levels Taught: *

Have you taken a NCTA 30-hour seminar or other East Asia survey for teachers before? If yes, when and where? *

Please type or paste in a statement (of two or more paragraphs) describing what you teach, how the seminar material would fit into your classroom, and what you hope to gain from the seminar. *

I am committed to completing the full 30-hour seminar and the 6-hour follow-up sessions, and understand that I will not receive the full benefits of the seminar unless I fulfill these commitments *

I agree

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