WPC& 2B Zn1 Authorized Gateway CustomerAuthorized Gateway Customerapplication. datastremeXC\  PQPDefault ParaV6>Default Paragraph Font(0*.?NocDE#XP\  PQXP#2e&0$QC\  PQP\  `*Times New Roman (TT)XP\  PQXP\  `*Times New Roman (TT)X \  PQP\  `*Times New Roman (TT)\  PQP\  `*Times New Roman (TT)^\  PQP\  `*Times New Roman (TT)[\  PP("  Z 6Times New Roman Regular:\  PP("  Z 6Times New Roman RegularA\  PP("  Z 6Times New Roman Regular&G\  P&P("  Z 6Times New Roman Regular&:\  P P("  Z 6Times New Roman Regular&G\  P &P("  Z 6Times New Roman Regular&:\  P P("  Z 6Times New Roman Regular&G\  P &P("  Z 6Times New Roman Regular&:\  P P("  Z 6Times New Roman Regular&G\  P&P("  Z 6Times New Roman Regular&:\  PP("  Z 6Times New Roman Regular&G\  P&P("  Z 6Times New Roman Regular&:\  PP("  Z 6Times New Roman Regular&G\  P&P("  Z 6Times New Roman Regular&:\  PP("  Z 6Times New Roman Regular&G\  P&P("  Z 6Times New Roman Regular&:\  PP("  Z 6Times New Roman Regular&G\  P&P("  Z 6Times New Roman Regular&:\  PP("  Z 6Times New Roman Regular&G\  P&P("  Z 6Times New Roman Regular&:\  PP("  Z 6Times New Roman Regular&G\  P&P("  Z 6Times New Roman Regular&:\  PP("  Z 6Times New Roman Regular&G\  P&P("  Z 6Times New Roman Regular&:\  PP("  Z 6Times New Roman Regular&G\  P&P("  Z 6Times New Roman Regular&:\  PP("  Z 6Times New Roman Regular&G\  P &P("  Z 6Times New Roman Regular&:\  P!P("  Z 6Times New Roman Regular&G\  P"&P("  Z 6Times New Roman Regular&:\  P#P("  Z 6Times New Roman Regular&G\  P$&P("  Z 6Times New Roman Regular&:\  P%P("  Z 6Times New Roman Regular&G\  P&&P("  Z 6Times New Roman Regular&:\  P'P("  Z 6Times New Roman Regulara\  P(P("  Z 6Times New Roman Regular&G\  P)&P("  Z 6Times New Roman Regular&:\  P*P("  Z 6Times New Roman Regular&G\  P+&P("  Z 6Times New Roman Regular&:\  P,P("  Z 6Times New Roman Regular&G\  P-&P("  Z 6Times New Roman Regular&:\  P.P("  Z 6Times New Roman Regular&G\  P/&P("  Z 6Times New Roman Regular&:\  P0P("  Z 6Times New Roman Regular&G\  P1&P("  Z 6Times New Roman Regular&:\  P2P("  Z 6Times New Roman RegularA\  P3P("  Z 6Times New Roman Regular&G\  P4&P("  Z 6Times New Roman Regular&:\  P5P("  Z 6Times New Roman Regular2&&3|x XX   # \  PQP#jThe DataStreme Project #\  PQP#VAMERICAN METEOROLOGICAL SOCIETY #^\  PQP##  DataStreme Course Participant Application Form ă #[\  PP# #:\  PP# This form consititutes formal application to the DataStreme Project Course. Please print or type.  Photocopies of this twopage form are acceptable.#A\  PP#  44 Return this form to: 4 <DL!T$#&G\  P&P# ******************************************************************************************* 4 <DL!T$ 1. Mr./Mrs./Ms./Dr. Name:_________________________________________________________________ #:\  P P#  (circle one)  << %(Last)*DD/4(First)9LL>C(Initial) #&G\  P &P# 2. Social Security Number ________________________________ 3. Name and address of your school:<< %*DD/49LL>Type of School: !T$#:\  P P# #&G\  P &P#__________________________________________________#:\  P P#7___Elementary?C___Inner City L!T$ #&G\  P&P#__________________________________________________#:\  PP#7___Middle SchoolC___Urban  #&G\  P&P#__________________________________________________#:\  PP#7___Junior HighC___Suburban #&G\  P&P# ____________________________ZIP___________________7#:\  PP#___High SchoolC___Rural #&G\  P&P# 7#:\  PP#___Other __________________________ 4 <DL!T$#&G\  P&P# School Tel:____________________________*DD/4School Fax:______________________ 4L!T$#:\  PP#44(area code)4(if any);(area code) 4 <DL!T$ #&G\  P&P# EMail Address, if available: ______________________________________________ #:\  PP#  44  << %*#&G\  P&P# 4. Residential Address << %*DD/4Home Tel:_______________________ L!T$ _________________________________________________4;#:\  PP#(area code) 4 <DL!T$#&G\  P&P# _________________________________________________  _____________________________ZIP_________________4Home fax:_______________________#:\  PP# #&G\  P&P# Desired Mail Address: #:\  PP#__Work __Home%*DD/#&G\  P &P#4#:\  P!P#(if any)#&G\  P"&P#9 #:\  P#P#(area code)#&G\  P$&P# 5. Application intended for enrollment in ____Fall*____Spring419____ 6. Employment record for the past 5 years #:\  P%P#(in reverse chronological order)#&G\  P&&P#: #:\  P'P#  Dates44  << Employer*DD/49Nature of Activity  #a\  P(P#Current position #&G\  P)&P# _______________________________________________________________________________________  _______________________________________________________________________________________  _______________________________________________________________________________________ 7. Teaching/supervising experience that has included science content. Describe content#:\  P*P#:#&G\  P+&P#  _______________________________________________________________________________________  _______________________________________________________________________________________  _______________________________________________________________________________________  _______________________________________________________________________________________ 4 <DL!T$(Complete back of form)4 <DL!T$8. Describe subjects, units or topics you teach or supervise, in which weather information is or could be used, including the number of weeks spent on them per school year: 4  _______________________________________________________________________________________  _______________________________________________________________________________________  _______________________________________________________________________________________  9. College or university education: #:\  P,P#  Institution  State<< Year%Degree*DD/4Major SubjectLL>CMinor!!H #&G\  P-&P# _______________________________________________________________________________________  _______________________________________________________________________________________  _______________________________________________________________________________________  10. List collegelevel courses, workshops and/or training sessions taken in meteorology or related fields: #:\  P.P# _________________________________________________________________________________________________________ #&G\  P/&P# _______________________________________________________________________________________  11. In what ways have you been involved with inservice teacher training and/or curriculum development?  _______________________________________________________________________________________  _______________________________________________________________________________________  _______________________________________________________________________________________  _______________________________________________________________________________________  _______________________________________________________________________________________  _______________________________________________________________________________________  _______________________________________________________________________________________  12. Acceptance to the DataStreme workshop requires a commitment to act as a resource person on promoting  the use of current weather information across your school's curriculum. Indicate ways in which you intend  to do this.  _______________________________________________________________________________________  _______________________________________________________________________________________  _______________________________________________________________________________________  _______________________________________________________________________________________  _______________________________________________________________________________________  _______________________________________________________________________________________  13. Equipment Requirements: !T$ Access to an Internet connection with Web browser to access the DataStreme Homepage.B___ Yes ___ No  Access to a fax machine to communicate with Datastreme Course facilitators.B___ Yes ___ No  Access to a printer that will allow me to print gif images from the DataStreme Homepage. ___ Yes ___ No 4 <DL!T$ 14. "The information given on this application is accurate and complete."   ___________________________________*DD/4___________________________ #:\  P0P# 44(Your Signature) << %*DD/49(Date) #&G\  P1&P# ******************************************************************************************* #:\  P2P#To be completed by your school principal or appropriate supervisor: #A\  P3P#"I recommend the above applicant as a DataStreme course participant and agree to facilitate the teacher's role as a resource person on the use of current meteorological data across the curriculum. The participant's school will make available a computer (MAC or IBM 386 or greater), printer, and a school Internet connection with a Web browser at least two weeks in advance of the course start date. The participant will also have access to a telephone facsimile machine for weekly transmissions and receipts. I will continue to support the participant at this level for at least one school year beyond course enrollment." #&G\  P4&P# _________________________________________*DD/_______________________________ #:\  P5P# (Signature)  << %*DD/49(Title)