Teaching in Community

Application Form

Applications are due by Thursday, April 30, 2009 for the 2009-2010 academic year. Applications will be reviewed by the co-facilitators. Participants will be notified the week of May 8, 2009.

Priority will be given to new full-time faculty and an effort will be made to represent as many academic areas as possible.

Please complete the below application form,
then click on the "SUBMIT" button.

Name:
Department:
Division:
Home Phone or Campus Extension:
Home Address:
E-mail Address: (Please Note: A valid e-mail address is required to process this form.)
Employment Status:
	Full-time
	Part-time
	DCE
Campus:
	Haverhill
	Lawrence
	Both
	Other
Please answer the following question:
Why I would like to participate in this project?