Take Flight Into Scientific Investigation
Celebrate the Centennial of Flight
October 4, 2003
Hosted by the Sumner County Regional Airport
Sponsored
by Tennessee State University &
Vanderbilt
University
NASA Ideas
Grant
Funding for this project comes from the NASA Ideas Grant
Name: ______________________________________________
School: _____________________________________________ District:
______________________________
County: _____________________________________________ Principal
Name: _______________________
Currently teaching:
¬ 2nd
grade ¬
3rd grade ¬
4th grade ¬ 5th grade ¬ 6th grade ¬
7th grade ¬
8th grade ¬
High School
Other ____________
School Information ___________________________________________________
street
address
________________________________________________________________
city,
state, zip
phone:
(w) ________________________
(fax) ________________________
email:
________________________________________
Home Information: ___________________________________________________
street
address
________________________________________________________________
city,
state, zip
phone:
(w) ________________________
(fax) ________________________
email:
________________________________________
To Register:
Email Judy Butler at judy@DragonflyEnterprises.org
to indicate that you are submitting an application then email or mail the
application to:
Judy
Butler
251
Cumberland Cr.
Nashville,
TN 37214
Please take a
few minutes to answer the following questions.
1.
Does your teaching license include certification in
science? ¬
yes ¬
no
2.
Please select the category that best describes your
school:
___Low poverty (poverty level
below 35%)
___Medium poverty (poverty
level between 35-50%)
___High poverty (poverty level
between 50-75%)
___Very high poverty (poverty
level above 75%)
¬
Check here if you are a Title I school
3.
Please select the category that best describes your
school:
___Under 35% underrepresented
groups
___Between 35-50%
underrepresented groups
___Between 50-75%
underrepresented groups
___Above 75% underrepresented
groups
Note: Information in questions
2 and 3 are needed for the funding agencies.
4.
What courses do you currently teach or is your class
self contained all subjects?
5.
Briefly describe how you include aerospace, space
education, and aeronautics in your curriculum.
Teachers agree to participate in the evaluation component of this project, which includes the following: (1) pre- and post-summer institute surveys; (2) journal of reflections; (3) possible classroom visits by workshop staff; and (4) possible audiotape interviews by workshop staff.
I agree:
______________________________________
ApplicantŐs Signature
Date: __________________________________________