Oklahoma Science Adventure Teacher’s Application

School Information
Teacher Name*
First Last
Teacher Email Address*
Student Name*
First Last
School Name
School Address
Street Address Address Line 2 City State ZIP Code
School Phone
School District
How many students attend your school?
What percentage of students at your school receive free/reduced lunch?
How did you hear about Oklahoma Science Adventure?*
Student Information
What grade(s) and subject(s) do you teach, and in which class(es) have you had this student?*
Does your school have a science club or other extra-curricular science opportunities? If so, please describe. Is this student involved in these opportunities?*
Tell us a little about this student. Please reference their interest and enthusiasm for science.*
Please provide us with your candid opinion of the student’s social, intellectual and personal capabilities. Please reference: personal integrity, academic ability, self-confidence, work habits, and teamwork skills.*
Students will be working with peers and scientists. What strengths does this student possess that will make him/her a good team member?*
Indicate strength of overall endorsement:*
Application Agreement*
I agree to the following.
I certify that to my knowledge that the information in this application has been completed accurately and honestly.
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School Information