This is the application for Previous Interns to continue their participation in the HHMI/NIH/MCPS Teacher Internship Program: IF YOU ARE A NEW INTERN, please click here to transfer to the application for new interns. Application Instructions: (1) To apply for this rewarding program, please submit the items listed online by January 11, 2008. Questions should be directed to Ms. Gloria Seelman (2) Be sure that you have the accurate e-mail address of your school principal. (3) Have a list of courses completed in biology and chemistry, with dates completed and grades earned. Indicates a required field!
1. Personal Information
Name:	Mr. Ms. Mrs. Dr.      First  MI  Last
E-mail Address:	userid@server.com To obtain a free email address, click here
Home Address:
City:
State:	(DC for Washington D.C.; NA if not US)
Zip:
Home Phone:	-
2. Professional Information
Current School:
Telephone Number at Work:	-
Grades or Subjects You are Currently Teaching, and the Name of the School where taught:	Grade/Subject School ---------------------------------------
Years in Teaching:
Years in MCPS:
3. Coursework and Grades:  Please list courses you have taken in biology and chemistry, the dates completed, and grades earned.
Course Title Institution Year Completed Grade ---------------------------------------------------------------
4. Personal Statement: Complete a one page description of an instructional unit you would like to develop by returning to a laboratory at NIH. This work may be an extended laboratory unit lasting a week or more. This must be an original activity derived from your NIH experience. The description should include the following: 1. introduction or background 2. questions to be explored 3. discussion of results 4. evaluation component 5. method to train other teachers to use the unit We recommend using a Word Processor to compose your Personal Statement and then cutting and pasting it into the box below.
5. Principal's Recommendation: After you submit this form, the principal you indicate below will be contacted to provide a recommendation..
Principal's Name	Required
Principal's Email Address:	Required

Please click on the "Submit Application" button below to complete the application.