Spring 2008 Mayhew
JILA PFC Partnerships for Informal Science Education in the Community (PISEC)
Teaching Opportunities

Name_________________________________________Email__________________________

Phone______________    Dept.______   Undergrad (year)_______  Grad Student (year)______    

       Post doc_________	Faculty__________

Which org’s are you a member of? (check all that apply):   JILA____LA Program _____	

Level of Commitment:

JILA (20 hours/yr) _________	LA Program (15 hours/semester) ______________

Other:  (2-3 hours/week)_________  One concentrated period (you tell us)__________

Other amounts of time (describe)___________________________________________________

Teaching experience: (Check all that apply)  None____   

Taken Ed. courses:______________________________________________________________

Outreach events (describe)________________________________________________________

LA/TA experience (courses, # semesters)____________________________________________

Instructor (college? K-12? # yrs?, courses)___________________________________________

Experience w/K-12 (incl. your own family/neighbors)?_________________________________

Preferences: (Check all that apply)  Grades:  K-6____  6-8_____ 9-12______

Activities: After school____ In class_______Remote________

Topics: (Check all that apply)   Physics___ Math____ Gen’l Science____ Other_____________

Is transportation an issue for you? ________________________________________________

What times of day are you available? (Include times between 8am-7:30pm at night)
Monday		Tuesday		Wednesday		Thursday		Friday