All application materials are due by March 29, 2013. Early applications are encouraged. Application materials are being accepted until positions are filled. Successful applicants will be required to arrive in Bloomington for staff training by June 12, 2013, a few days prior to the start of the Summer Science Camp.

Mail recommendation forms (3) to:

2013 Adventures in Science Summer, Indiana University (DEMA)
107 South Indiana Avenue/Bryan Hall 115
Bloomington, IN 47405-7000

If you have questions or need additional information, contact the camp by phone at 812-856-5700 (ask for "Summer Science Camp") or by e-mail at demastem@indiana.edu

Indiana University is an Equal Employment Opportunity/Affirmative Action employer and a provider of ADA (Americans with Disabilities) services.


"Adventures in Science, Technology, Engineering, and Mathematics" Summer Science Camp Staff Application Form

Please check the position(s) for which you are applying (you may check more than one):

Lead Day Counselor
Day Counselor
Lead Night Counselor
Night Counselor
Instructor
Assistant Instructor
Technology Counselor
Nurse (RN)



Name: (first)     (middle)     (last)
Mailing Address:

(city)     (state)     (zip+4)
Home Phone:     Cell Phone:
Best time to call:
E-mail address:
Gender*: male   female

*Gender information will only be used to ensure adequete staff coverage for male and female student camp participants


1. ALL APPLICANTS--Education:


Level of Education School Name/Location Major/Minor Diploma/Degree Dates of Attendance
Graduate
2nd Graduate (if applicable)
Undergraduate
2nd Undergraduate (if applicable)
High School


2. ALL APPLICANTS--Work Experience Other Than Teaching Over the Last 10 Years:


Employer Address Position Held Dates of Employment


3. ALL APPLICANTS--Professional Certificates or Licenses:



Type:
State:     Expiration date:
Endorsement(s):
Type:
State:     Expiration date:
Endorsement(s):


4. INSTRUCTOR APPLICANTS ONLY--List ALL Teaching Experience Chronologically (start with current or the most recent):


Name of School School District/City/State Position Held/Subject Taught Dates (Mo/Yr) Total Years


5. ALL APPLICANTS--Awards or Recognition Received:



6. ALL APPLICANTS--Memberships, Organizations, and Other Community Experience/Participation:



7. ALL APPLICANTS--Attach a description of how you think your background and experience make you a good fit for this position.


(Please limit answer to 4000 characters, including spaces. We recommend typing your answer in word processing software and pasting the text into this form. Use only plain text with no formatting.)


8. INSTRUCTOR APPLICANTS ONLY--Attach your philosophy of teaching your content area.


(Please limit answer to 4000 characters, including spaces. We recommend typing your answer in word processing software and pasting the text into this form. Use only plain text with no formatting.)


9. INSTRUCTOR APPLICANTS ONLY--Attach a lesson plan that you taught related to the Science, Technology, Engineering, or Mathematics.


(Please limit answer to 4000 characters, including spaces. We recommend typing your answer in word processing software and pasting the text into this form. Use only plain text with no formatting.)

10. ALL APPLICANTS--In order to complete your application, we must receive recommendation forms from three (3) professors, supervisors, or employers not related to you. Please provide the name, title, address, phone number, and e-mail address of those persons who will submit recommendation forms on your behalf:






11. ALL APPLICANTS--How did you learn about the Indiana University Summer Science Camp? Please check all that apply:


Poster
Web
Newspaper (which one? )
Radio (which one? )
TV (which one? )
Word of mouth
Other (please specify)


I certify that all the information submitted by me on this application is true and complete, and I understand that if any false information, omissions, or misrepresentations are discovered, my application may be rejected and if employed, my employment may be terminated at any time.

In consideration of my employment, I agree to conform to the camp's rules and regulations, and I agree that my employment and compensation can be terminated, with cause, and with notice, at any time, at either my or the camp's option. I also understand and agree that the terms and conditions of my employment may be changed, with or without cause and with or without notice, at any time by the camp.

To agree to the terms above, place your initials here:     Date (mm/dd/yyyy):

Please print a copy of your application for your records before you submit.