Science Teachers Program Application

Complete the appropriate sections below to submit your nominees or submit your own application for the Arkema Inc. Science Teachers Program.

Principal Section

Please complete this section. If the nominated teacher(s) have not filled out their portion of this application, an email will be sent asking them to do so

School information

School name*

School address*

School state*

Phone*

Grades*

Choose the Arkema facility nearest to you

School principal*

School Principal Email*

School city*

School ZIP*

Fax

School enrollment*

I nominate two teachers, both are from grades 3, 4, 5 or 6. (Or teachers can come from grades 3 & 4 or 5 & 6.) All fields are required.

Name*

E-mail address*

Grade*

Phone number*

Secondary email address

Name

E-mail address

Grade

Phone number

Secondary email address

In the space provided below, please indicate how your school might benefit from participation in the Arkema Inc. Science Teachers Program.

Is your school committed to greater use of hands-on activities in your science program? Please describe existing or planned initiatives: Describe your school’s current access to STEM related funding and resources, such as materials, curriculum, and staff: Describe the hands-on science kits currently used at your school:

No kits

A few kits

Several, well furbished kits

How will the recommended teachers provide enthusiastic leadership for science reform at your school? Please explain how the applicants will share their experiences with fellow teachers:

Clicking send will generate an email to the teacher(s) you nominated asking them to complete their portion of the application. If you are receiving this from a teacher, then clicking send will finish the application process and we will notify you of your acceptance. Thank you!