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ASCP Fall 2006 Participant Application Form
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If you are an educator and have an interest in participating in the Armenia School Connectivity Program, please complete and submit the following application. This information will be used to select a suitable partner for you, so please be as detailed as possible.
The deadline for all applications is September 25, 2006.
If you have questions about the application process, please direct them to:
For U.S. Teachers:
Shawn Umansky, U.S. Program Manager
Armenia School Connectivity Program
(802)496-4545, ext. 117
shawn@projectharmony.org
For Armenian Teachers:
Karine Gevorgyan, Events and Exchanges Senior Coordinator
Armenia School Connectivity Program
(37410) 260686, ext. 205
karine@projectharmony.am
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| EDUCATOR INFORMATION: |
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First Name |
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Last Name |
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Home Address |
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City |
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State |
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Zip Code |
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Home Phone |
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Cell Phone |
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Personal Email |
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Personal Web Site |
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Work Address |
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City |
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State |
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Zip Code |
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Work Phone |
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Work Fax |
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Work Email |
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What is the most effective way to contact you? When is the best time to reach you? |
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Please list any countries to which you have traveled, and for what purposes (i.e., pleasure, work, mission project, etc.): |
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Please list any languages you speak, other than English: |
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How did you find out about the Armenia School Connectivity Program? |
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| SCHOOL INFORMATION: |
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Name of School |
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Type of School |
public
private
charter
magnet
secondary
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Would you describe your community as: |
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School Web Site |
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What type of the internet connection does your school have? |
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What is the speed of your school's internet connection? |
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On a scale from 1 through 10, with 10 being the highest, please rate the reliability of your school's internet connection:
1 2 3 4 5 6 7 8 9 10
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| TECHNOLOGY INFORMATION: |
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Please rate your knowledge in the following areas on a scale from 1 through 10, with 10 being the highest:
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General Computer Use
1 2 3 4 5 6 7 8 9 10
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Microsoft Word
1 2 3 4 5 6 7 8 9 10
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Microsoft PowerPoint
1 2 3 4 5 6 7 8 9 10
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Email
1 2 3 4 5 6 7 8 9 10
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World Wide Web
1 2 3 4 5 6 7 8 9 10
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Web Logs/Video Logs
1 2 3 4 5 6 7 8 9 10
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Online Web Forums
1 2 3 4 5 6 7 8 9 10
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Other:
1 2 3 4 5 6 7 8 9 10
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| CLASSROOM INFORMATION: |
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Timetable and Activities:
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How do you integrate technologies into the education process (i.e., online resources, web sites, etc.)? How often? |
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| PRIOR EXPERIENCE: |
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Please list any events, activities, or programs (online projects, workshops, seminars, conferences, etc.) organized by Project Harmony and/or ASCP in which you and/or your school have taken part:
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| GENERAL INFORMATION: |
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How do you feel participation in this program will benefit your students? |
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What do you hope to achieve through this program? |
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What qualities would you look for in a suitable online teaching partner? |
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Do you or your students have any special needs? |
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Outside of teaching, what hobbies or interests do you enjoy? |
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Why do you want to participate in this program? |
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Please provide experiences, such as similar programs you have participated in, or other factors that would make you a good candidate for this kind of international program. |
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Below are the project options currently available for Fall 2006 partnerships. Please select your preferred project from the list below or use the "additional comments" space at the end of the application form for alternative subjects of interest. |
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First Choice:
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Second Choice:
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Third Choice:
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Additional Comments: |
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