First Name:
Last Name:
Email:
Secondary Email:
Phone Number:
School Name:
School Address:
School City:
School State:
-- Select One --
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California
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Connecticut
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District of Columbia
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School Zip:
xxxxx or xxxxx-xxxx
Principal First Name:
Principal Last Name:
Principal Email:
Your Home Address:
Your Home City:
Your Home State:
-- Select One --
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virgina
Wisconsin
Wyoming
Your Home Zip:
xxxxx or xxxxx-xxxx
Metropolitan Locale:
-- Select One --
Urban School
Suburban School
Rural School
Grade Taught:
-- Select One --
3
4
5
Have you ever applied for the Mickelson ExxonMobil Teachers Academy before?
Yes
No
How did you hear about the Mickelson ExxonMobil Teachers Academy?
TV advertisement
TV news
Newspaper
Radio
Online
e-card, certificate, or postcard
Recommendation of friend/colleague
Other
After reading the MEMTA mission and goals, why is it important for you to be part of this Academy?
Describe your teaching philosophy. Include the key ideas that foster learning with understanding for each child in your classroom.
Reflect upon a recent teaching experience in math and/or science. Describe that lesson in terms of teaching for learning. Include the interactions between teacher and student, student and student.
What assessment strategies and/or tools did you use to assess the results of the above lesson? What would you do next and why?
Why are math and science important subjects for your students?
I have read and accept the terms and conditions relating to the Mickelson ExxonMobil Teachers Academy – Send My Teacher application.
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