STEM Rural Ohio Fellowship Application Home > Forms > STEM Rural Ohio Fellowship Application "*" indicates required fields First name:* Last name:* Email* Please specify your race/ethnicity:* American Indian or Alaskan Native Asian Black, Non-Hispanic Hispanic Multiracial White, Non-Hispanic Other/Unknown Prefer not to answer Phone*Your school:* Your school's IRN number:*You can find your IRN here: https://oeds.ode.state.oh.us/SearchOrgClassification that best describes your school* Rural Small town Suburban Urban Please see the Ohio Department of Education's guide to school district types.County of your school* Is another educator from your school applying?* Yes No Co-applicant name* First Last Co-applicant email* Grade levels in your school:* K 1 2 3 4 5 6 7 8 9 10 11 12 How many students do you impact?*Principal's full name:* Principal's email* Your role:* Teacher Lead teacher Other What is your experience with place-based or problem-based learning?*Please note, this is not a pre-requisite. Is your school STEM/STEAM designated?* Yes, STEM Yes, STEAM No Has your school ever applied for the STE(A)M designation? If so, when?*Please note, this is not a pre-requisite. Please describe the STEM practices that have been established in your school, if any.*Please refer to the Quality Model for STEM and STEAM schools. Please note, this is not a pre-requisite. STEM Hub region your school belongs to:* Akron Central Ohio Dayton Northeast Ohio Northwest Ohio Southeast Ohio Southwest Ohio For information Hubs, please visit our Hubs Page https://osln.org/schools-hubs/hubs/ Acceptance to this professional learning program requires a commitment to attend and participate in all program events. The participant will communicate directly with the OSLN program manager in case of any emergencies that would prevent the participant from attending.* Yes, I understand and agree I don't agree Would you like to sign-up for future emails from OSLN about events and professional development opportunities? Yes No
