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
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

GEMS Professional Development Application   

Session to attend:

(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.

  1. Have you used GEMS, GEMS Sequences, or Seeds of Science Roots of Reading units with students? If so, which units?
  2. 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:

  1. Have you used GEMS units with students? If so, which units?
  2. Have you presented a GEMS workshop for teachers? Describe region served, length of workshop, how many participants, grade levels, and guides presented.
  3. Have you presented other science and/or math workshop for teachers? If so, please describe.
  4. How does/will your district or institution support you in providing future GEMS workshops for teachers? (funds, materials, inservice time?)
  5. 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?)
  6. 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:

Accommodations and Transportation Information

For credit card payments

Cardholder Name:_____________________________________

Card Number:_____________________________________

Expiration Date:________________________________

Card Type (Visa or MasterCard):_____________________________________

Lawrence Hall of Science    © Monday, 05-Jan-2009 21:28:00 PST UC Regents. All rights reserved.    Contact GEMS    Updated Wednesday, 26-Nov-2008 14:19:47 PST