Selection of workshop participants is competitive and based upon an applicant's potential to integrate workshop content into their teaching.
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Personal Data |
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| First Name: |
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| Last Name: |
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| Preferred Phone*: |
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| Preferred Email*: |
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| * To contact you with questions and/or notifications. |
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| Institutional Data |
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| School or Institution Name: |
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| City, State: |
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| School Type: |
2-yr. College
4-yr. College
High School
Other, please describe
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| Student Info |
| Approximate number of students at your institution: |
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Selection Criterion 1: Professional Qualifications and Teaching Experience
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| Academic degree(s) and major(s): |
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| Additional science training: |
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| Total number of years teaching: |
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| Courses taught in the last 5 years: |
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| List any professional development/training in which you have participated in the last seven years, including any interactions with the DNA Learning Center: |
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| Briefly describe any involvement in professional societies and precollege/community STEM outreach: |
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Selection Criterion 2: Implementation
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| Briefly describe why you are interested in attending this workshop: |
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| Briefly describe any teaching or research experience incorporating bacteriophages, biomanufacturing, or in-vitro systems: |
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| Briefly describe how you anticipate incorporating what you learn in this workshop, especially in relation to particular courses: |
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| Briefly describe any plans to disseminate what you learn to colleagues: |
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| Additional Information (Does not affect selection) |
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How did you find out about this workshop?
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DNALC email
DNALC direct mail
On the DNALC Internet site
At a convention or trade show
Link from an Internet site
Internet search
Word of mouth
During a visit to the DNALC in Cold Spring Harbor
Through InnovATEBIO
Through the QUBES Nanopore Network
From Oxford Nanopore or Oxford Nanopore Education Beta Program
Through a supply or equipment company (such as Carolina Biological Supply Company)
Other (please specify)
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| I have previously attended a DNALC, CyVerse, InnovATEBIO, or IUSE workshop: |
No
Yes (Please specify year and title)
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| Travel Support |
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Will you need travel and subsistence support to attend? |
No
Yes (Describe where you will be traveling from, your mode of travel (car, train, airplane), and approximate cost)
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