ALSAE application

ALSAE application

This scholarship is only available to educators that work in an Alabama Public School System.

Today's Date*

First Name*

Last Name*

Home address*

City*

State*

Zip*

School email*

Alternate email

Phone number*

Phone

What School District do you work for?*

*This scholarship is only available to educators that work in an Alabama Public School System.

School Name*

Principal's Name*

Principal's email*

Subject taught*

Grade taught*

Have you previously attended Space Camp for Education?*

Yes

Does your school support an underserved or underrepresented population?*

Yes

Does your school serve a Native American population?*

Yes

Is your school Title I?*

Yes

I understand that the ALSAE program is conducted in a camp setting that includes some physical activities that include walking, bending, and climbing in both inside and outside areas.*

I understand/agree

I have concerns

I understand that some aspects of the program involve space simulation experiences such as the astronaut-style trainers that may increase heart rate and have a weight limit restriction of 260 pounds. These are optional activities.*

Yes

I understand that if I am selected, I will be charged a 25.00 attendance deposit upon registration. This deposit will be refunded in full when you attend the camp. However, if you do not attend the camp, or cancel by email in a timely manner, you will forfeit the deposit.*

Essay Response*

'Please write a brief essay describing what you hope to gain from your ALSAE experience.'

(Please limit to 300 words)

Signature*

Session Preference*

Due to the overwhelming success of the ALSAE program, we will host two sessions for Alabama teachers in 2024. Please check the session you would prefer to attend.

Please note - this is a preference, we cannot guarantee you will be assigned to your preferred session, as the spaces are filled as scholarships are awarded.

Select Preferred Session:

Session 1 arrives June 12, and graduates June 17

Session 2 arrives June 19, and graduates June 24

Send me a copy of my responses

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