OWP Pre-registration Form


Please fill out this form and mail it to:

Nathaniel Teich, Project Manager
Oregon Writing Project
Center for Advanced Technology in Education
5214 University of Oregon
Eugene OR 97403-5214




PREREGISTRATION APPLICATION

Name __________________________________________

Home address ___________________________________

City _______________________________ Zip _________

Home phone __________________

Social security number ___________________________

Current teaching assignments (by subject and grade level, not individual courses)

* Elementary _____________ * Middle School _________________

* Junior High _____________ * High School ____________________

* College _________________ * Other _________________________

School __________________________________________

School address ___________________________________

City ______________________________ Zip ___________

School phone __________________

E-mail address ________________________________________________

Include with your address and data (above) the following material:



* a brief summary of your educational background and teaching experience, including college degrees (one page)

* briefly describe your experience with computers in education, including type of systems you can use

* describe one of your classroom activities involving writing (need not involve computers) that you could demonstrate to our workshop



Do you wish to be considered for the following grant awards?

partial tuition scholarship for those without other support

stipend for those living beyond commuting distance to campus

Please sign your application as your agreement to accept the responsibilities of an institute participant.

Signature _____________________________

Date ___________________________

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