Elementary GREENTREE FOUNDATION TEACHERS’ ECOLOGY WORKSHOP Elementary Name*Home Address*City*State*AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificZip*Home Phone*Cell Phone*Personal Email*School District:*Building*School Address*City*State*AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificZip*Position*Work Phone*Work Email*How do you prefer to be contacted?* Personal Email Work Email How did you hear about the Greentree Foundation Teachers’ Ecology Workshop?* Web search for professional development programs Referral Other If Referral or Other, Please SpecifyNYS Teaching Certification Area:*Will you apply for Professional Development credits?* Yes No Teaching Grade Level* K-3 4-6 Other How often do you teach science?* Not Often (less than 2 times per week) Sometimes (2-3 times per week) Frequently (more than 3 times per week) On a scale of 1 (not confident) to 5 (very confident), how confident are you in teaching science?* 1 2 3 4 5 What science topics do you teach during the year?*What nature-based education topics do you teach during the year?*How often do you teach outside?* Not Often (less than 2 times per week) Sometimes (2-3 times per week) Frequently (more than 3 times per week) Why are you interested in being a participant of the Greentree Foundation Teachers’ Ecology Workshop for Elementary School Teachers? How do you think it will enhance your classroom and lesson plans? Please be as thorough in your response as possible. Thank you.*