AWSM Community Action in the Classroom

Professional Development Workshop

Monday 7/16- Wednesday 7/18, 2018

at our Spruce Knob Mountain Center

Circleville, WV

www.Experience-Learning.org

LEARN fun ways to teach science and other subjects through your local watershed
EXPLORE scenic Spruce Knob, the highest point in West Virginia and the Chesapeake Bay watershed
INTEGRATE civic action into your classroom
EARN a $375 stipend
3 continuing education graduate credits from Marshall University are available for an additional fee.

Workshop details:

COST - $300 includes room, board, field experiences, and materials.

SCHOLARSHIPS- scholarships are available. Details below.

GUESTS- family and friends are invited to enjoy the scenary or participate in workshop activites. $65/person.

Register below and please contact Kellee Waddell for more details: 304.567.2632 or kwaddell@experience-learning.org

Registration and Medical Release Form

Contact Information

Name

First Name

Last Name

Address

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Verify Email

Preferred Phone Number

Are you a teacher or non-formal educator?

Yes

School Affiliation

If you are an educator, what school, agency, or organization are you affiliated with?

Grade Levels

Grade(s) or age range(s) you anticipate teaching in 2018/2019?

Team Members

We encourage teachers to sign up as a part of a school team. If another teacher from your school is also signing up please list their name(s) below. (We are particularly interested in supporting cross-discipline teams).

Lodging Preference (Monday night and Tuesday night)*

Lodging in our shared dormitory-style rooms is available. Or, bring a tent and camp under the stars.

I'd like a bed in a shared dorm room (pillows, sheets, and blankets are provided)

I'd like to tent camp (you'll need to bring you're own camping equipment)

I'll be commuting and will not need lodging

Sunday Arrival

If you'd prefer to arrive Sunday 7/15/18 please check here

Yes

Allergies or Dietary Restrictions:

Please list any allergies, including dietary restrictions (food allergies, vegetarian, lactose intolerant, etc.) We always have vegetarian options and will do our best to accommodate dietary restrictions. Please be specific and include information for any guests as well. If you are bringing an Epipen, please bring two, as well as the appropriate dose of oral Benadryl due to our remote location.

Guests

Please list any guests who will be coming with you. (A guest is anyone who will be coming with you to the Spruce Knob Mountain Center who will not be participating in the workshop sessions. Spouses, children, BFF's are welcome! Cost is $65 to cover meals. Space is limited so apply early)

Payment Information

$300 for workshop participants and $65 per guest. Fees include room, board, and materials.

Scholarship Information

A limited number of scholarships are available to help reduce costs for educators. Please choose from a scholarship option below:

$50 scholarship (you pay $250)

$100 scholarship (you pay $200)

$250 scholarship (you pay $50)

Payment Type

Check (please make check payable to Experience Learning)

Pay via phone

Pay with Credit Card using this form

Amount

**We request the balance be paid in full two weeks before the program to confirm your participation in the workshop.
If we cancel the program for any reason, you will receive a full refund. Please mail checks to:

Experience Learning
18 Woodlands Way
Circleville, WV 26884

If you would prefer to pay by phone, please call our office at (304).567.2632
For information on scholarships or other general inquiries please contact Kellee Waddell at the office number listed above,
or at kwaddell@experience-learning.org

Connect with us!

Experience Learning sends occasional news and upcoming event updates. If you are interested in joining our electronic and/or physical mailing list, please enter your preference(s) below.

Yes, please send updates to the physical address above

Yes, please send updates to my email address

Please do not send me anything.

Comments

Add 3% to my total amount to help cover the payment processing fees