Connecting Middle School and College Mathematics

APPLICATION FOR (CM)2 WINTER 2003 OUTREACH COURSES

Please fill out by December 12, 2002.

Participants will be notified of acceptance by December 30, 2002.

Name:

Home Address: Phone:

City: Zip:

E-mail Address:

Bachelor's Degree:
Institution: Major: Year:

Do you have a teaching certificate?

If your answer is YES, what level and content area? (if you have more than one certificate, list all certificates)
1st certificate: level content area:
2nd certificate: level content area:
3rd certificate: level content area:

Have you taught any of the following (with or without a certificate): Elementary, Middle School, or High School? If so, please list which ones.

Subjects you have taught:

Please list the college mathematics courses you have taken.

Which courses are you interested in taking during Winter 2003?

Are you interested in possibly taking future outreach courses during the academic terms (FS2003, WS2004) and/or during the coming summer (SS2003)? If so, please list which semesters.


Funded by a grant from the National Science Foundation.


For further information, contact Project Director--Ira J. Papick
E-mail:

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