SciTrek 2021-2022 Sign-Ups
Use this form to sign-up for SciTrek modules. If you are signing up for a slot that accommodates two classes use one form for both classes. For schools that have only one class per grade level you can use one form for two grades if the classes will occur in the same time slot.

In order for SciTrek to be sustainable, the program needs to work with teachers on developing their abilities to run student-centered inquiry-based lessons on their own in their classroom. To be fully prepared for modules, teachers need to take on an active role by both attending the orientations that correspond with the modules their class will be doing and by participating in the classroom. For those that job share, both teachers are required to attend orientation for their class as well as attend each day of the module that falls upon their respective days. Additionally, if more than 1 day of the module is missed, priority registration for the next year will be affected.
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District *
School: *
Principal's Name: *
School Address (include zip): *
School Phone: *
Teacher 1 *
Name:
email address *
Home Phone: *
Home Address (include zip) *
Current Grade Level *
Grade Level(s) previously taught
Do you job share? (If "yes," please enter info in "Job share teacher" below) *
Job share teacher's name, contact information, and grades previously taught:
Does your classroom have a document camera? *
Teacher 2
Name:
Email address
Home Phone:
Home Address (include zip)
Current Grade Level
Clear selection
Grade Level(s) previously taught
Do you job share? (If "yes", please enter info in "Job share teacher" below)
Clear selection
Job share teachers name, contact information, and grades previously taught:
Does your classroom have a document camera?
Clear selection
Is there any other information that we need to know for planning purposes?  Example: You have a combo class or would like to include a combo class in your sign up.
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