Please complete and use additional sheet if needed.
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Name
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School Address
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City/State/Zip
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School Phone
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Principal Name
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School County
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Home Phone E-mail
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Home Address
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City/State/Zip
Highest Degree Received: ______________________ University:________________________________
Major: _____________________________________ Date: ___________________________________
Other College Study: __________________________ University: _______________________________
Major: _____________________________________ Date: ___________________________________
Teaching Experience (give subjects taught and grade level for each):
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____________________________________________________________________________________
____________________________________________________________________________________
_____________________________________________Number of years teaching: __________________
Previous courses you have taken on Arkansas history:
____________________________________________________________________________________
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Please indicate your particular interests in social studies teaching:
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
What are your expectations of this workshop? ____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
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In addition to the above:
1. Include a brief statement on why you want to participate in the project and
how you will use this experience.
2. Request an administrator or supervisor (your principal is preferred) to write a letter in support of your application.
Please mail, fax, or e-mail all materials by May 1, 2002 to:
Business Manager
Arkansas Historical Association
University of Arkansas
History Department, Main 416
Fayetteville, AR 72701
Mary Herrington
Office Phone: 479/575-5884
Fax: 479/575-2775
E-mail: mherrin@uark.edu