Lockheed Martin/UCF Academy for Mathematics and Science

Scholar Information Form

Please print and fill out.
Name: Mr./Ms./Mrs./Miss
Social Security Number:
School: County:
Home Address: 
City/State: ZIP:
Home Phone: Work Phone:
E-mail: 

Teaching History (begin with the present):

 

 

 

 
Years: School: Grade:
What grade level are you presently teaching?  

Please name the principal of the schools at which you are presently employed

 

List the areas in which you are certified to teach

 

 
Teaching certificate number

Academic history

 

 
College/University Dates Attended Degree
What was your undergraduate point average?
Have you ever been accepted for a graduate program at UCF?
If so, indicate the program area and year.
Have you taken the GRE in the past five years?
If so, what was your score? Verbal Quantitative
If not, when is your scheduled test date?

List membership in professional organizations

 

 

List any professional development acivities that you have conducted for your school or school district

 

 

List any awards or recognitions you have received

 

 

What have you done in your classroom to try to "turn your students on" to mathematics and science?

 

 

Describe your personal and professional use of technology.

 

 

On a separate sheet, list your professional development activities and/or professional readings in the areas of mathematics and science in the last three years. Describe how the professional activities and/or professional readings have influenced your teaching (keep to one page).

On a separate sheet, briefly describe your career goals. How could the Lockheed Martin/UCF Academy help you to achieve these goals?

 

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Last updated: September 22, 2003