Team Application for SEIR*TEC School Leadership in Technology Academy Mail or fax this application form and the individual forms for team members to: Vicki Dimock, Southwest Educational Development Laboratory, 211 East Seventh, Austin, TX 78701. Fax: 512/476-2286. Download application in Word format Application forms must be received on or before April 10, 2000. School or District: ____________________________ Names and Position Titles of Team Members (attach an individual form for each person listed here): ___________________________________________ ___________________________________________ Describe your student population (Percentage Free and Reduced Lunch, Percentage Limited English Proficient, Ethnicity): __________________________________ __________________________________________ Please respond to each of the following:
A signature of a school official who has authority to commit school/district resources to support team members travel, lodging, and meals while in attendance at the SEIR*TEC School Leadership in Technology Academy is required. My signature below indicates my full understanding of the commitment I will be making if our application is accepted. I agree that team members will be in complete attendance and will participate fully in the SEIR*TEC School Leadership in Technology Academy, June 13 - 16, 2000. ___________________________________________ Signature Title Date
For additional information regarding the SEIR*TEC School Team Academy, please contact Vicki Dimock at 1-800-476-6861, extension 219 or by e-mail at . |