Registration for the U.S. History and Public Health UCCI Teacher Exchange

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Thank you for registering for the UCCI Teacher Exchange for the UCCI Course U.S. History and Public Health. Location: Oakland Unified School District Office: 1000 Broadway, Suite 680 Oakland, CA 94607.

Please fill out all fields completely before submitting your registration form. The deadline to register is May 15, 2017. There is no cost for attending, and a working lunch is provided both days of the event.

For more information about UCCI's Teacher Exchange Program, please go here: http://ucci.ucop.edu/ucci-exchange/

We look forward to seeing you!

First Name *

Last Name *

Title *

E.g. "Math Teacher," "Assistant Principal"

Affiliation *

Please list the school and/or school district where you work.

Phone number *

Best email to reach you *

Please provide an email address that you check on a regular basis.

What subject(s) do you teach? *

In which content areas do you need support designing and implementing curriculum? *

The academic content and skills in my course of focus

The CTE content and skills in my course of focus

Both the CTE and academic content and skills in my course of focus

Other:

What do you hope to get out of participating in this event? *

Please tell us any individual or site-specific objectives you have for attending.

Please tell us anything else you think UCCI should know about your school or the kind of support you need that will help us as we plan this event. *

I understand that by registering for this event, I'm committing to doing the following in preparation: 1) reading through the course framework in its entirety, and 2) generating a list of questions/concerns I have about the course that I will bring to the event. *

I certify that I have read the above and understand its implications.

Required

Special Meal Requirement *

If you are vegetarian or vegan, please select the appropriate option below. If you have a food allergy, please select, "Other" and specify your food allergy.

Vegetarian

Vegan

None

Other:

How did you hear about this opportunity? *

Colleague or supervisor

Web search

UCCI staff

UCCI newsletter

Other:

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