2016 IAGD Accessible Field Course Application
This application is for Trip B of the 2016 IAGD-GSA Accessible Geoscience Field Trip in Denver, Colorado, open to middle and high school students with disabilities and current science teachers, with or without disabilities. Teachers do not need to have a student in their school attending to participate.  Students do not need to have a teacher in their school attending to participate.

Complete the following form and click on SUBMIT to complete your application. When you are finished, be sure to hit the SUBMIT button before leaving this page or your information will be lost.

If you are accepted for the workshop, you will be asked to complete a registration form to provide us with more information.  You will also be directed to register through the GSA Field Trip site.  
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Participation Status *
First Name *
Last Name *
Age (Students Only)
If you are under the age of 18, please provide the name, phone number, and email address for your parent or guardian.
What is the name of your Institution or School? *
City *
State/Province *
Zip Code *
Country *
Phone Number *
Email Address *
Gender *
Status of Ability *
(choose all that apply)
Required
Citizenship *
How did you hear about this opportunity? *
(choose all that apply)
Required
Student Questions
What grade will you be starting in the fall of 2016?  (Students Only)
Teacher Questions
Are you applying to participate in this trip with any of your students?
Clear selection
What is your highest level of education?
Clear selection
What science courses have you taught?  (be sure to include grade levels)
Are you a veteran of the military?
Extended Response Questions
We encourage you to compose your answers to these questions in a word processor and then cut and paste the resulting text into this form. This gives you access to conveniences like spell checking as well as the opportunity to save and reflect on your work before submitting.
Describe your interest and experience in earth science.  If you have ever participated in an outdoor earth science field trip, tell us about what you liked or disliked, and what you learned.  
(Student Response Only)
Describe your experience in providing accessible instruction or accommodating students with disabilities.  If you have previously conducted any accessible course work outside of the classroom?  If so, tell us about the content focus, objectives, how it went, and what you learned as a result.
(Teacher Response Only)
Describe how your participation in this field course will have an impact on your future efforts. *
(Both Student and Teacher Response)
If there is other information relevant to your application, please let us know here:
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