Application form

APPLICATION

For A.P.P.L.E. Summer 2012
In-Service Faculty Position in Lithuania

Starred (*) fields are required.

First name*

Last name*

Preferred mailing address*

Employer*

City*

Zip*

Country

State or Province (USA or Canada)*

Home phone* ( nnn-nnn-nnnn)

Home fax

Cell phone

Work phone

Work fax

Primary e-mail*

Secondary e-mail

Date of birth (optional)

Place of birth (optional)

Please check the program for which you are applying:*

Summer Seminar (two weeks: June 25 – July 5)
Dr. Algirdas Grigonis Program (Special Education Program) (two weeks: June 25 – July 5)
Dr. Algirdas Grigonis Program (Special Education Program)(three weeks: June 25 – July 13)
Camp Viltis (two weeks: June 25 – July 5)

Is this your first experience with A.P.P.L.E.?:*
Yes
No

Please check one:*
I am a fluent Lithuanian speaker and would be teaching in the Lithuanian language.
I would be teaching in English through an interpreter.

Please check all applicable areas of expertise:*

Administration & Supervision	Agricultural Education	Art, Dance, Drama
Computers/Information science	English as a Foreign Language (EFL/ESL)	Health Education
Library and Information Science	Music Education	Physical education
Elementary Education Focus (please specify)	Psychology Phychological services in schools	Preschool and Early Childhood Education
Language arts Communication and Public Speaking Journalism & Media Interface Linguistics / Language Acquisition Literary Analysis Writing	Mathematics Algebra Calculus Geometry General Trigonometry	Religion and Ethics Catholic School Philosophy and administration Instructional Methods Spirituality issues
Science Biology Chemistry Earth Science Environmental Sciences Physics	Social Studies Business Basics Economics Geography History Political Science	Social work Alcoholism & Substance abuse Conflict Resolution Basic and Family Counseling School Social Work Suicide Prevention
Curriculum and Instruction Assessment and Evaluation Cooperative Learning Critical Thinking Curriculum Development Educational Research Human Development Integrated Curriculum Learning Theories Teacher & Resource Center Development	Special Education Behavior Management Blind education Deaf education Inclusion/mainstreaming Management of Learning Disabilities Music therapy Physical therapy Special Populations (please specify)	Other areas:
Special needs or requests: Please identify any food restrictions or allergies. Also if you have a medical condition, please note it in this section. If you require any medication, please travel with it in your carry-on luggage. Materials: Please identify any materials that you need A.P.P.L.E. or the location to provide for your seminar. Short summary of your proposal* (Give subject and main topics for discussion):

Please e-mail your résumé and complete description of proposal to: karl.janowitz@temple.edu, smsabo@aol.com, KMDunlap@alumni.wfu.edu or send them together with the professional recommendation (first time applicants, only) no later than Dec. 21, 2011.

Please mail your professional recommendation (1 copy to each of the three addresses, new applicants only) within two weeks from submission date of this application but no later than Dec. 1, 2011:

Mrs. Shirley Sabo
118 Cook Rd.
Prospect, CT 06712

Dr. Katherine M. Dunlap
P. O. Box 626
Star NC 27356-0626

Dr. Karl Janowitz
219 Catharine Street
Philadelphia, PA 19147

Thank you for your interest in A.P.P.L.E. and Lithuanian education.

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APPLICATION

For A.P.P.L.E. Summer 2012 In-Service Faculty Position in Lithuania

For A.P.P.L.E. Summer 2012
In-Service Faculty Position in Lithuania