MRSEC RET Application 2023

Q1.

MRSEC Research Experiences for Elementary School Teachers 2023 (2nd-5th Grade)

Completion of this application is required in order to be considered as a participant in the RET program. The RET program will run from June 12 to July 19, 2023. You will be expected to participate in all research and research related activities for the duration of the program. If you have questions about the application or selection process, please contact Program Director, Risa Hartman at rhartman@che.utexas.edu.

Q2. First Name

Q3. Last Name

Q4. Permanent Address

Q5. School District

Q6. Name of the campus or campuses where you currently teach

Q7. Campus Address

Q8. Work phone number

Q9. Cell phone number

Q10. Email address (use the email that you will check daily)

Q11. Grade levels you currently teach (check all that apply to you)

2nd

Multiple grade levels

3rd

Multiple grade levels and multiple content areas

4th

Multiple grade levels of one content area

5th

Q12. List your teaching experiences (starting with most recent) for the last 10 years listing Year, Subject, Grades taught, and Campus. EX: 2015, Science, 5th, Cowan Elementary School

Q13. Your Academic Record - Next to the degree completed, fill in the date of completion. Mark N/A if that particular degree is not applicable.

BA

BS

MA

MS

Ph.D

Other

Q14. For each degree completed, identify the institution and major course of study. Mark N/A if that particular degree is not applicable.

BA

BS

MA

MS

PHD

Other

Q15. List Professional Memberships - State & National (EX: CAST) (If none, write NONE)

Q16. List Professional Conferences Attended and Conference Presentations/Sessions Conducted (If none, write NONE in the text box))
EX: CAST - 2014, CAST - 2013 - Presented Project Based Learning in a Physics Classroom

Q17. Identify all your research experiences as an undergraduate, graduate, job/career, internships and professional development
EX: Undergrad research assistant in Chem E, Grad research Lab Assistant in Dr. Li's Lab

If none, Write NONE in the text box

Q18. How will the MRSEC RET experience support your professional goals and your students' learning?(Minimum response length is 250 words)

Q19. Describe how you will use the MRSEC RET experience to teach a unit of study to your students and identify your approach. (Minimum response length is 250 words)

Q20. Complete a statement of purpose telling us: why you would like to participate in this program, describing yourself as a teacher, your teaching philosophy around student learning, and what skills/experience you most hope to take away from the RET program. (Minimum response length is 500 words)

Q21. Provide the name, title, and contact information of two references. Your references should include a current building administrator and a teaching colleague familiar with your teaching strategies and teaching philosophy

Click to write Choice 1

Click to write Choice 2

Q22. Please select the research areas that are your primary interests in the order of your preference (1=first choice, 2=second choice, 3=third choice, 4=fourth choice, 5=fifth choice, 6=sixth choice, 7=seventh choice, 8=eight choice )

Electrical Engineering
Chemical Engineering
Mechanical Engineering
Engineering Mechanics
Materials Science
Physics
Chemistry
Molecular Biosciences
None

Q23. Please identify your preferences regarding your primary work location for the summer. We will do our best to match you with a mentor at your desired campus, but we can not guarantee you will get your top choice.

Q23. Please identify your preferences regarding your primary work location for the summer. We will do our best to match you with a mentor at your desired campus, but we can not guarantee you will get your top choice.
	Mark 1=first choice, 2=second choice
Main UT Campus
Pickle Research Campus

Q24. Upon completion of this application we ask that you send an electronic copy of your resume or CV to Risa Hartman at rhartman@che.utexas.edu

Yes, I will submit an electronic version of my resume or CV to Risa Hartman upon completion of this application.

Q25. No person shall be excluded from participation, denied the benefits of, or be subject to discrimination under any program or activity sponsored by The University of Texas at Austin System or any of its component institutions, on any basis prohibited by applicable laws, including, but not limited to race, color, national origin, religion, sex, or handicap.

Yes, I have read the statement and understand

Q26. I certify that all general information provided on this application is complete and correct.

Yes, I submit my application