This on-line application is shown on one page so that you can copy and paste easily if you want to prepare answers offline, then submit later. That said, we do encourage early submissions. No bonus points are awarded for being the last before the deadline :)

General Information:

Last Name:
First Name (preferred):
Email:
Preferred Contact Phone:
Institution:
Dept:
Personal web page:
Are you applying with a partner or group from your institution? Yes No
Name of person(s) applying with:
Do you already own a Tablet PC? Yes No
Are you an HP TFT awardee (any year) -- if you don't know, choose No: Yes No
I understand that as a TFT awardee, I will NOT be given a grant for $1600 to buy a Tablet PC

Institutional Information
(Numbers can be approximate)

How many undergraduates does your campus serve? <1000 1000-5000 5000-10,000 10,000-15,000 >15,000
How many majors are there in your department? <20 20-50 50-100 100-300 300-600 >600
Is your institution (choose all that apply): Private Public Minority or underrepresented group serving
If minority serving, describe your demographic:
What best describes your institution: liberal arts regional college or university community college R1 institution Other If other:
Does your department teach any significant service courses? Yes No
How many full-time, tenure track faculty are in your department? <5 5-10 10-20 20-30 >30
Does your institution have an IRB (Institutional Review Board - or Human Subjects Board) Yes No
Have you ever submitted a proposal to an IRB? (It's OK if you haven't, we're just interested) Yes No
Are you willing to submit an IRB to seek consent to report on findings from active learning using UP? Yes No

About You, in the next year:

A big part of this project involves YOU doing really interesting things with UP in your classrooms next year. As such, we're interested in your thoughts on those classes.

What courses do you expect to teach in the next year? Please fill in one row in table for each course (up to 5). If you will teach the course more than once, you can indicate that in the description.

Name/Description	Estimated Num Students	Serves students in what year (1-4)	Service Course?	Taught Before?	Like to use Active Learning?
1)			Yes No	Yes No	Yes No
2)			Yes No	Yes No	Yes No
3)			Yes No	Yes No	Yes No
4)			Yes No	Yes No	Yes No
5)			Yes No	Yes No	Yes No

For each of the classes you entered above please enter a brief discussion below of the issues you see facing the course and the potential you see for improving or supporting it with active learning with UP. Also, please note if you think UP is not appropriate for this course and why.

Class 1)

Class 2)

Class 3)

Class 4)

Class 5)


What is your teaching load per term? 1 2 3 4
Is your school on semesters (2 per year) or quarters (3 per year)? Semesters Quarters

We're all very busy people -- believe us, we know :) But at a guess, how much time can you imagime devoting to using, assessing, and interacting with others about UP next year? (beyond class prep time) More than 2 hours a week 2 hours a week 1 hour a week 1 hour every other week Less than that

People are often interested in using UP for a variety of reasons.
Rate your level interest in each of these factors:
1) Using UP to change/support my teaching practice Not interested Somewhat interested Interested Very interested This is my main purpose in attending
2) Using UP as a vehicle for research
(e.g. on student learning, active learning, STEM education, technology in education): Not interested Somewhat interested Interested Very interested This is my main purpose in attending
3) Using UP to explore novel teaching practices and technologies Not interested Somewhat interested Interested Very interested This is my main purpose in attending

The Essay Section :) (word limits are merely guidelines, not enforced)

What is your definition of "active learning" in the classroom (as based on your personal and professional experience in your field)? (100 words)

Explain why you value active learning through the following context: Of the courses you have taught in the past few years, which of them have been taught involving significant active learning components, which have not used active learning significantly and what was the rationale for the pedagogy employed? (300 words)

Describe any efforts in assessment (in learning, of curriculum, etc.) with which you have been involved. Or education-lreated research publciations(<100 words)

Details

In this section, we pose a series of general questions we'd like you to answer. Our purpose here is primarily one of open communication - we seek to make clear our expectations and goals for workshop participants and, conversely, to make it clear to participants what they can expect to "get out of" this workshop. Answering negatively on any particular question does NOT mean you won't be selected for the workshop.

Answer	Question
Yes No	I intend to teach at least two courses in the next academic year using active learning as the primary in-classroom pedagogy.
Yes No	I have access to a digital projection system to be used in the classes I intend to teach.
Yes No	Students in my class will have access (either through lab computers or required laptops/tablets in class) to web-browser and internet connected technology DURING lecture meetings.
Yes No	Students in my class will be encouraged to bring their own personal laptops to lecture meetings. If so, approximately what percentage of the student body in your classes owns laptops (you might take a straw poll in a class you have now)
Yes No	My department will be supportive of my efforts to use technology to enable and study active learning in my classes.
Yes No	My department or institution will support my purchase of a Tablet PC above the grant amount provided by the workshop (grant amount is $1600. You should expect to spend ~$2200 on a properly equipped Tablet PC).
Yes No	I will complete the required pre-workshop activities including readings, equipment purchases, software installs, and surveys.
Yes No	I will complete, in a timely way, the required Institutional Review Board processes to gain consent to report on student use of the Tablet PC system for active learning.
Yes No	I will participate in post-workshop meetings and communication including voice over IP meetings the academic year after the workshop.
Yes No	I am looking forward to contributing to multi-disciplinary discussions and analysis of active learning.
Yes No	I am looking forward to contributing to the research literature in my field on active learning.

If you have any questions about the workshop that you would like to have answered, please do not hesitate to contact Beth Simon (bsimon@cs.ucsd.edu).