STEM Robotics 101 Professional Development

The information below will be used to determine your eligibility for Tier 1 and Tiers 2 Scholarships. Registration priority will be given to Tier 1, then Tier 2 and finally Tier 3 applicants *(Tier 3 slots, if available, will be allocated on a first-come, first-served basis).

Teacher First Name*

Teacher Last Name*

Teacher Email Address*

Principal First Name*

Principal Last Name*

Principal Email Address*

City*

School Name*

School District*
Enter the name of your school district

Education Service District*

Select the Best Training Location & Date*
More detailed information will become available in a few weeks.

Feb 22 & 23, Tacoma (Fri eve/Sat) Mar 25 & 26, Vancouver ESD 112 (9-3:30) Apr 11 & 12, Pasco (Thurs/Fri 8-2:30) Apr 15 & 16, NCESD Refurbishment Center, East Wenatchee (Mon Eve 4-8 pm/Tues 8-4:30) Apr 18 & 19, Yakima ESD (Thurs/Fri 9-3:30) Please let me know about future dates

Grade Level Target(s) for Robotics Class
Select all that apply

K-3 Original

Grade 4 Original

Grade 5 Original

Grade 6 Original

Grade 7 Original

Grade 8 Original

Grade 9 Original

Grade 10+ Original

Estimated number of students impacted per year
Not just class size, the estimated number of unique students enrolled in STEM Robotics 101 per year

Scholarship Information
OPTIONAL: Required for scholarship consideration for teachers with highly under-represented student populations.
Note: You will be notified if you qualify for a Tier 1 ($200) or Tier 2 ($100) scholarship and a Principal Letter of Support will be required at final registration.

OSPI’s 2016/17 Washington State Report Card:
http://reportcard.ospi.k12.wa.us/summary.aspx?year=2016-17&yrs=2016-17

Under-represented Group 1:
What is your school's Free or Reduced-Price Meals rate? (from 2016/17 OSPI Report Card)

Under-represented Group 2:
What is the sum of your school's population rate for non-White and non-Asian students? (from 2016/17 OSPI Report Card: 100% minus White %, minus Asian %)

Under-represented Group 3:
Is this an SPED Class?

Yes No Other

Under-represented Group 3 Other
If you selected Other for Group 3, please enter more detail here

Under-represented Group 4:
What is your school's Transitional/Bilingual rate? (from 2016/17 OSPI Report Card)

Under-represented Group 5:
Is this a required class for all students? (i.e. effectively 100% of female population enrolled)

Yes No Other

Under-represented Group 5 Other:
If you selected Other for Group 5, please enter more detail here

Under-represented Group 6:
Is this an ALE Class?

Yes No Other

Under-represented Group 6 Other:
If you selected Other for Group 3, please enter more detail here

Send me a copy of my responses

Email address