Teacher Registration

To respond to this voluntary registration, fill in the following form.

To answer a question, type an x. For fill-in-the-blanks, type in your response.
1. Name:

    

2. School Name and Address:
    

3. E-mail address:
    

4. Grade Level (please check only one)
     Choose one:

    lower elementary

    upper elementary

    middle school

    high school

    Other, please specify:

    Home schooling, please specify ages taught:

5. Subject(s) taught:
     Choose one:

    generalist

    science specialist

    Other specialist, please specify...

6. What is your main interest in using Passport to the Solar System?

     Choose one:

    For ideas and activities to use with my students

    As a professional development experience before using this type of resource with my students

    Other, please specify...

7. Number of students with whom you will use Passport to the Solar System?
     Please enter a numerical value only:

    

8. How would you describe the size of the area in which your school is located?
     Choose one:

    rural

    suburban

    small city

    medium/large city (over 1,000,000)

9. Which previous Passport to Knowledge modules have you participated in?
     Choose all that apply:

    Live from Antarctica (the 1995 original)

    Live from the Stratosphere

    Live from the Hubble Space Telescope

    Live from Mars

    Live from Antarctica 2

    Live from the Rainforest
    
    Live from the Sun

    Live from the Storm

    Live from Mars 2001

    Passport to the Universe

    Passport to Antarctica

    Passport to the Rainforest

    Passport to the Weather and Climate

    none, this is my first experience with Passport to Knowledge 

10. How often have you used online curriculum projects other than Passport to Knowledge modules?
     Choose one:

    Many times

    A few times

    Once

    Never

11. Are you planning to team teach this curriculum?
     Choose one:

    Yes

    No

12. I am most interested in:
     Choose all that apply:

    Hands-on activities for use in class

    Reference and resource materials to augment my existing lessons in this area

    Communication with other teachers who are interested in this subject matter 

    Good educational uses of the Internet

    Online collaborative projects that involve exchanges with other classrooms

    Interviews and exchanges with scientists and technicians working in this field

    Exciting video programs to help explain this subject matter to my students

    Other, please specify...



Thank you for completing this registration!