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DREAM Lunar Extreme Program Teacher Application Form Application Checklist A complete application package should include This form completed Current resume / curriculum vitae Two-page essay Letter of commitment Student Application Materials for 4-6 students Please mail your complete application package to DREAM Att Heather Weir SSAI 10210 Greenbelt Rd Ste 600 Greenbelt MD 20706 APPLICATION DUE BY December 12 2011 Please send an email notification once you have submitted your application. See the Announcement of Opportunity for an overview Email Address Home Address Home Phone School/Organization Name and Address Personal Information Applicant s Name Work Phone/Fax Position/Title include grade level s taught Vitae Include a current resume or curriculum vitae with your application package. Essay Prepare a two-page essay describing how you will utilize the information you acquire during the Lunar Extreme Program and Lunar Extreme Workshop. Letters A written letter of commitment from your host institution to express willingness to support you in these efforts from January through June 2012 including participation in the Lunar Extreme Workshop June 18-22 2012 at NASA Ames Research Center. School Schedule Please let us know when does your school return from winter/holiday break when does your school have any semester breaks when does your school year end and is your school a year round school of the DREAM Lunar Extreme Program including the provided resources and the responsibilities. DREAM Lunar Extreme Program Teacher Application Form Application Checklist A complete application package should include This form completed Current resume / curriculum vitae Two-page essay Letter of commitment Student Application Materials for 4-6 students Please mail your complete application package to DREAM Att Heather Weir SSAI 10210 Greenbelt Rd Ste 600 Greenbelt MD 20706 APPLICATION DUE BY December 12 2011 Please send an email notification once you have submitted your application* See the Announcement of Opportunity for an overview Email Address Home Address Home Phone School/Organization Name and Address Personal Information Applicant s Name Work Phone/Fax Position/Title include grade level s taught Vitae Include a current resume or curriculum vitae with your application package. Essay Prepare a two-page essay describing how you will utilize the information you acquire during the Lunar Extreme Program and Lunar Extreme Workshop* Letters A written letter of commitment from your host institution to express willingness to support you in these efforts from January through June 2012 including participation in the Lunar Extreme Workshop June 18-22 2012 at NASA Ames Research Center. School Schedule Please let us know when does your school return from winter/holiday break when does your school have any semester breaks when does your school year end and is your school a year round school of the DREAM Lunar Extreme Program including the provided resources and the responsibilities.

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