UVa-JLab Electricity and Magnetism Program
July 28 - 8, 2014

Application Deadline - 5:00 PM May 30, 2014

Please visit http://people.virginia.edu/~ral5q/classes/UVa-JLab/summer13/ for specific program information.

Personal Information

First Name: Last Name:

Address 1:

Address 2:

City: State: Zip Code:

Phone Number: () -

Email address: Confirm email address:

Country of Citizenship*:

*Appointments can be awarded only to U.S. citizens or to Permanent Resident Aliens. The latter required a copy of both sides of the alien registration card be submitted.

Employment Information

School Name:

City: State: Zip Code:

School District:

Phone Number: () -

Fax Number: () -

Principal's Name:

Principal's Email:


List in reverse chronological order the colleges/universities attended in formal degree programs, and the highest degree earned:

What is the highest level course in mathematics you have completed? Knowledge of some geometry, trigonometry and algebra is necessary for this program.

Professional Experience

Number of years you have taught science:

Current teaching assignments, including grade levels:

Teacher Certification subject(s):

Personal Statement

Please discuss your reasons for applying for this program. Please indicate how you expect your participation in this program to benefit your teaching.

Participant Commitment and Responsibilities

Please read the following carefully and click on yes, no, or undecided. Be aware that your acceptance into the program may depend on your commitment to fulfill the expected obligations unless otherwise noted.

• Summer and Fall 2014 Responsibilities: Complete the UVa-JLab summer program at Jefferson Lab from July 28 to August 8, 2014 - five days a week, 8 hours per day. You will complete 10 labs and activities at Jefferson Lab and submit them for grading. UVa faculty and Jefferson Lab staff of experts will be available for assistance. Complete 5 labs and activities at home in September through October. Help will be available online using discussion board, email, and videos. Completing these activities can earn you 3 credit hours of PHYS 6263, a Graduate Level Electricity and Magnetism course for science teachers. You are expected to register online to earn the credit from UVa. How to register online, course requirements, lab assignments, and tuition cost can be found here.

I will register for PHYS 6263 and pay tuition in a timely manner and complete all summer and Fall activities to the best of my abilities.

yes    no    undecided

• Fall 2014 and Spring 2015 Responsibilities: Integrate new pedagogy and subject into teaching your science electricity and magnetism SOL material.

I will consider and try to teach by inquiring processes via the Nature of Science and give a pre and post student learning assessment when we reach the appropriate subject matter in the curriculum.

yes    no    undecided

• Complete written assessments and evaluations surveys in a timely manner as made available to you online. Surveys will be done anonymously except for assignment of your PHYS 6263 grade which will be assigned by the instructor of record.

I will complete all assessment and evaluation surveys in a timely manner knowing that they are being conducted anonymously and analyzed by a professional external evaluator.

yes    no    undecided

• Videotaping is voluntary and not required. It is not part of determining the participants' grade and your acceptance into the program is not based on whether you do this activity. If you wish to participate, you may videotape yourself teaching new material keeping students identification anonymous. You may blur out student faces. You may also opt to prepare video in a rehearsal setting at home or classroom without students. Edit the video down to illustrate your best 5 minute presentation. A free video cam and mini tripod will be available to teachers who commit to participate.

I will present a video at the PDI-VAST conference (November 20-22, 2014) in Norfolk, Virginia.

yes    no    undecided

Send My Application!