Academic Year 2005 - 2006 Form
Participant Form
Return by April 18, 2005 to:
Barbara Beyerbach
Swetman Hall SUNY Oswego
Oswego, NY 13126
________I will Participate in SMART |
________I will NOT participate in SMART |
Name_________________________________________________ |
Address_______________________________________________ |
Home Phone ___________________________________________ |
Email__________________________________________________ |
School Address_________________________________________ |
School Phone___________________________________________ |
Teaching Subject and grade level_________________________
Current Team: |
Delaware__________________________________________ Huntington________________________________________ Henninger_________________________________________ Onondaga Nation____________________________________ New York City______________________________________ YALG_____________________ Healthworks_________________________________________ Oswego County (specify GESA, PDS, Teacher Work Sample, other) |
ETE Exchange_________________________________________ |
Other_______________________________________________ |