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About the AWM Teacher Partnership

AWM Teacher Partnership Request Form

Required fields are denoted by * .

Name*:
   
Affiliation and current position, OR, experiences in mathematics or mathematics education*:
   
Professional Organizations
   
Address*:
   
Phone:
   
Email:*
   
I would like to partner with:
An elementary school teacher
A middle school teacher
A high school teacher
A university teacher
A mathematician in industry
An independent mathematician
An independent mathematics educator
A mathematician in academia
Someone in my geographical area
I am:
Female
Male
The maximum number of pairs I would like to be involved with is:
One
Two
Three
I would be best matched with someone who is interested in: (You may choose more than one.)
A particular area in mathematics
   (Please specify: )
Educational issues
Curricular issues
Gender issues in mathematics education
Career issues
Learning about the life in a different mathematics community
Other
    (Please specify: )
I would like to pair with someone who is:
Novice in the field
With seven years of experience
With over fifteen years of experience
Other
   (Please specify: )
The length of time I have been in my current career is:
1-6 years
7-15 years
Over fifteen years
Other
   (Please specify: )
I prefer to partner with:
a Female
a Male
an African American
an Asian
a Caucasian
a Hispanic/Latino
a Pacific Islander
other
   (Please specify: )
I am (you may choose more than one):
African-American
American Indian
Asian
Caucasian
Hispanic/Latino
Pacific Islander
Other
   (Please specify: )
My area(s) of interest is (are):
Comments, questions, or suggestions:
How did you hear about the AWM Teacher Partnership Program? (Check all that apply.)
AWM Web Site
AWM Newsletter
AWM Teacher Partnership Flyer
Newsletter from other organizations
   (Please specify: )
Word of mouth
Other
   (Please specify: )
Please print a copy of your request form for your own record before hitting submit. If at any point you need to update the information you gave us, including your email/mailing address, please inform the organizers.
  

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