MicroGlobalScope Application

Application for Schools

Q.1

Your name *

Title

First Name

Last Name

Q.2

School name *

Q.3

School address *

Address Line 1

Address Line 2

City/town

State/Province

Post Code

Country

Q.4

Email address *

(e.g. john@example.com)

Q.5

Phone number *

Q.6

Please give some background information about your school *

e.g. aims of school, private/public and any other relevant information.

Q.7

What grade do you teach and what is the age of your students? *

Q.8

How many students are in your classroom? *

MicroGlobalScope may be run as an in-class or afterschool activity. Please estimate the number of students.

Q.9

Is your school population under-served and/or lacking in science resources? *

Q.10

Please describe your climate and any geographic features of your location *

e.g. monsoonal climate, high altitude, volcanically active, temperate climate etc

Q.11

Please describe the environment in your school's vicinity. Are there any natural bodies of water and/or terrestrial biomes nearby? *

e.g. "We have easy access to ponds and urban street puddles", "Much of the area surrounding our school is undeveloped, forested terrain", "Our school is located 20km from hot mud pools".

Q.12

We're looking for teachers with drive and passion. Please describe any previous projects you have undertaken with your class, to engage your students in educational opportunities beyond the basic curriculum. *

Q.13

Have you previously used the internet or web technology to create an in-class or extra-curricular activity for your students? If yes, please describe. *

Q.14

Please select your level of English profiency *

Until we are able to provide instructions in other languages, a moderate understanding of English will be necessary to participate.

fluent
moderate - able to understand spoken and written english
poor

Q.15

Are your students proficient in English? *

It is not necessary that students be fluent in English. This will help us determine what books we can provide for the students.

yes
moderately - students are able to follow instructions in English
no

Q.16

If English is not the primary language of instruction at your school, please list your language below.

Q.17

Does your school have internet connectivity and a computer that can be used for the project? *

yes
no

Q.18

When is your school in session? *

Please include the approximate dates of your school's summer holidays.

Q.19

If your school is in a remote location, please describe how goods can be delivered to your class.

Q.20

As a teacher in the MicroGlobalScope project, will you able to assist your students with using the microscopes (including taking microscopic photos and videos) and will you be able to upload photos and videos to the website on behalf of your class? Participating schools are expected to make at least one blog post per week. *

yes
no

Q.21

How did you hear about MicroGlobalScope? *

From a colleague or friend
Via the Science House website
Via an online search
Other:

Q.22

If you have any further comments, please leave them below.