INSTRUCTOR APPLICATION FORM

College in the Schools

Part A: Teacher Information

Name
Name on your transcript(s), if other than that above
Home address
City, state, ZIP
Home phone
Home e-mail
School phone (your direct line)
School e-mail
Total number of years you have taught high school
Total number of years you have taught upper division
In what subject areas?
Total number of years you have taught lower division
In what subject areas?
Specific subjects that you have taught that relate to the University subject for which you are applying
Undergraduate degree(s) (example: BA)
Undergraduate institution(s)
Graduate degree(s) (example: MAT)
Graduate institution(s)
Other significant education

Part B: Application Information

Academic year you intend to begin teaching the U of M CIS course or subject you are applying to teach? (example: 2015-16)
Are you applying to replace a teacher who is currently teaching the U of M course or subject you are applying to teach? / Yes No
If so, who would you replace?
Is this the first CIS course that has been offered at your school? / Yes No
Is this the first time this subject or course is being offered at your school through CIS? / Yes No


Which course or subject are you applying to teach?

English and Communications Studies / Social Sciences
Introduction to Literature / Introduction to African American Studies (pilot in 2015-16)
Introduction to Public Speaking / Principles of Micro/Macroeconomics
Writing Studio (Entry Point Project) / American History
University Writing / American Democracy in a Changing World
Mathematics / Multicultural Perspectives in Sociology (Entry Point Project)
CSE Calculus I / Introduction to Psychology
College Algebra through Modeling (Entry Point Project) / World and Classical Languages
Basic and Applied Statistics (pilot in 2015-16) / Modern Chinese
Sciences / French
Introductory Animal Science / German
Essentials of Human Anatomy and Physiology / Hebrew
Introductory College Physics I / Japanese
Physics by Inquiry (Entry Point Project) / Latin Prose / Poetry
Plant Propagation / Classical Greek
Spanish

Part C: High School Information

School
Address
City, state, ZIP
School phone
School web address
What state legislative district is the high school in?
Principal’s name
Principal’s e-mail
Guidance counselor’s name
Guidance counselor’s e-mail
Financial officer’s name (this person will serve as the contact for the U of M Third Party Billing Office)
Financial officer’s e-mail
Financial officer’s phone
Grades served by your school / 9 – 12 10 - 12
Approximate size of the student body
Number of instructional days at your school
Number of minutes in a period at your school
Term over which this course will be taught / Semester Trimester 2 Trimesters Quarter Full year Block (please describe)
Other (please describe)


Part D: District Information

District name and number
Address
City, state, ZIP
Phone
District web address
Superintendent’s name
Superintendent’s e-mail
Curriculum director’s name
Curriculum director’s e-mail
Gifted and talented coordinator’s name
Gifted and talented coordinator’s e-mail
District PR/communications coordinator’s name
District PR/communications coordinator’s e-mail

Part E: Entry Point Project Information

Teachers applying to teach an Entry Point Project course should answer the following additional questions. Schools are not required to offer AVID or a comparable program, but CIS does consider having AVID or a comparable program a plus. (Entry Point Project courses are noted on the course list in Part B.)

Does your school offer an AVID program in which 11th and 12th grade students can participate? / Yes No
If you school does not offer AVID, does it have another program that provides academic support to students wanting it? / Yes No
If so, please attach a description of the program.

A complete College in the Schools application includes ALL of the following:

Instructor Application Form

Letter of interest explaining reasons for wanting to teach the U of M course

Resume

Official transcripts of all undergraduate and graduate study, both degree and non-degree; either mailed directly from the institution to the CIS office or enclosed in its own envelope sealed by the Registrar’s Office at your college/university

Letter of recommendation from your high school principal

School Partnership Agreement form signed by your principal