Note: This application is for funding from ScEnMaT program only. If selected as a ScEnMaT participant, you will be instructed to submit a separate application for admission to UND Graduate School. More Information

APPLICATION FOR FUNDING FROM ScEnMaT (2009)

(All fields marked with a * must contain a valid input)

1.Contact Information

Name
 
*Last
*First
Middle

*Email

*Phone
  Home/Mobile Office

Fax

*Address
(Home) Street 1 Street 2
 
  City State Zip

*Address
(Office) Street 1 Street 2
 
  City State Zip

*What is the best way to get in touch with you?
E-mail Home Phone/Mobile Office Phone

2. Your Interest in UND's Math, Science, and Engineering Program

*What subjects areas are you interested in (prioritize your choices)?

1st Choice
2nd Choice
3rd Choice


*What courses are you applying for? **
2009 Summer 2009 Summer + 2009-2010 Online

**University/SBHE approval for these courses and certificate programs are pending. More Information


3.Professional Information

* I am licensed to teach in North Dakota
*Are you presently teaching in a ND public school ? Yes No
School(s) you are teaching in
 
School district

*Is your school district a "High Need" LEA? Yes No
( Click here for the list of High Need LEA's in North Dakota)

*What subjects/Grades does your current teaching license permit you to teach?
Subject   Level/Grade(s)
for
for
for
for
for

Subjects/Grades you have taught within the last 5 yrs.
Subject   Level/Grade(s)
for
for
for
for
for

4. Benefits to your students, school/school district, and yourself

*How would your participation in this program benefit your future students(150 words max)?
*How would your participation in this program benefit your school/school district(150 words maximum)?
*What personel/professional goals do you hope to meet by participating in this program(150 words maximum)?

5. References

* Superintendent of your school district (Supporting letter required)

Name
E-mail
Phone
Address
(office) Street
City
State
Zip

*Principal of your school (Supporting letter required)

Name
E-mail
Phone
Address
  Street
City
State
Zip

Third reference (Supporting letter optional)

Name
Occupation
E-mail
Phone
Address
  Street
City
State
Zip

6. Comments (Optional)

If applicable provide additional information that you feel may strengthen your application.


7.Certification


* I have asked the principal of my school and the superintendent of my district to send recomendation letters to:

Dr. Lars Helgeson
Education Room 304A
231 Centennial Drive,Stop 7189 
Grand Forks, ND 58202
phone:701.777.3144, fax:701.777.3246

I intend to have ESPB review my transcripts

*By typing my initial below, I certify that the information provided by me in this application is accurate to the best of my knowledge.

Please note that your application process is not complete until:
1. We have received letters of recommendation from your school principal AND school district superintendent, and
2.You have received an e-mail from us stating that your application is complete.

Contacts for Information:
Dr. Lars Helgeson Dr. Kanishka Marasinghe
Ph. 701 777 3144 Ph. 701 777 3560
lars.helgeson@und.nodak.edu k.marasinghe@und.edu