GEMS Professional Development Application
- Print this form to mail or fax us your
application and payment. You may also register online using our secure form.
University of California, Berkeley
GEMS Professional Development
Lawrence Hall of Science # 5200
Berkeley, CA 94720-5200
Fax (510) 643-0309
Name ____________________________________________________________
(as you would like it to appear
on your name tag)
Colleague's Name (if applicable)____________________________________________
Institution/Work Address________________________________________________
City _______________ State ____ Zip ________ Work Phone (____) __________
e-mail ______________________________
Position ______________________________ Grade
Level Involvement _________
Home address____________________________________________________
City _______________ State ____
Zip _________
Home Phone (____) ____________
We encourage teams of people from the same community to take advantage
of the discounted team rates. Team members must each fill out an application
and return them together in the same envelope. Visa or MasterCard accepted
(please include: Cardholder's Name, Card Number, Expiration Date).
Make check/purchase order to: Regents of the University of California
(Additional discounts apply for those attending multiple workshops. Contact Terry Cort as indicated below for specifics.)
Associate's Professional Development
criteria (this section not applicable to GEMS After Schoool Science workshop):
Your application will be evaluated in part based on your responses to the
questions below.
Please attach a separate sheet of paper with your responses.
- Have you used GEMS, GEMS Sequences, or Seeds of Science Roots of Reading units with students?
If so, which units?
- For Seeds of Science/Roots of Reading sessions only: Please tell us what science and reading curricula you currently use, how many hours weekly you use each, and where you heard about this program. Do you currently have any of the units in the Seeds of Science/Roots of Reading line?
Associate's workshop applicants only, please also address these questions:
- Have you used GEMS units with students? If so, which units?
- Have you presented a GEMS workshop for teachers? Describe region served, length of workshop, how many participants, grade levels, and guides presented.
- Have you presented other science and/or math workshop for teachers? If so, please describe.
- How does/will your district or institution support you in providing future GEMS workshops for teachers? (funds, materials, inservice time?)
- What are your plans/opportunities for GEMS leadership in the coming years? Please include: Approximately how many workshops do you plan to present per year? Whom will your workshops serve? (If teachers, what grade levels? From your district? County? State?)
- Team applicants: How do you and your team members plan to work together to provide GEMS leadership in the future?
- Mail completed application and payment
to:
- University of California, Berkeley
GEMS Professional Development
Lawrence Hall of Science # 5200
Berkeley, CA 94720-5200
Make checks payable to "Regents of the University of California." For more information, contact GEMS Workshop Administrator Terry Cort
at (510) 643-0672 or reach her by e-mail: tcort@berkeley.edu
Accommodations and Transportation Information
For credit card payments
Cardholder Name:_____________________________________
Card Number:_____________________________________
Expiration Date:________________________________
Card Type (Visa or MasterCard):_____________________________________
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