Academic Year 2006 - 2007 Form

Participation Form

 

Return this form to:

Project SMART
SUNY Oswego
252F Wilber Hall
Oswego, New York 13126

___  I will participate in the SMART 2006 Summer Institute.

___  I will not participate in the SMART 2006 Summer Institute.

_________________________________________________________________________

Comments-National Board Certification:

___ I am interested in learning more about the National Board Certification process.

___ I plan to go through the National Board Certification process.

___  I have already begun the National Board Certification process.

___  I am already a National Board Certified teacher.

__________________________________________________________________________

Comments- Worksample:

___  I am interested in learning more about the Teacher Worksample.

___  I plan to develop a Teacher Works ample to illustrate and reflect on student learning in my classroom

 ­___  I have already  begun developing a Teacher Worksample.

__________________________________________________________________________

Comments-GESA:

___  I am interested in participating in a GESA (Generating Expectations for Student

       Achievement) awareness session.

___  I have participated in a GESA awareness session and am interested in participating in 3­

       day facilitator training.

For GESA Facilitators:(check all that apply)

___  I have implemented GESA in my classroom.

___  I have shared GESA with peers in my building.

­­­­­­___ I have participated in a GESA study group.

___  I have facilitated a GESA study group.

___  I have conducted research on the impact of GESA.

Other Comments:

 Name: ________________________________________________                       

 Home phone number:____________________________________

 School phone number____________________________________

 School name___________________________________________

 School Address:________________________________________

 Current email:________________________________________