The
Western Kentucky University Writing Project
Application
NOTE: This version cannot be submitted electronically. Please feel free, though, to print out copies for your use and for other interested individuals. Be sure to print and complete all three web pages.
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Return by February 21, 2014 to:
Peggy Otto
English Department
WKU Writing
Project
Western Kentucky University
(To be completed by the
teacher)
1906 College Heights Blvd. #11086
Bowling Green, KY 42101-1086
Applicant's
Name______________________________________
Date________________
Home
Address_______________________________
Phone_______________
________________________________
School Address______________________________
Phone_______________
_______________________________
School
Fax__________________________________
e mail_______________
EDUCATION (start with most recent)
Name of
Institution
Dates of Attendance
Degree Date Received
__________________________
________________
_______ _______________
__________________________
________________
_______ _______________
__________________________
________________
_______ _______________
Fields of Study:
________________________________________________________________
EXPERIENCE Total years experience:______
(A) List the teaching positions you have held, beginning with the current
year.
Name of
School
Dates
Grade Levels
Subjects Taught
____________________ ________
____________ __________________
____________________
________
____________ __________________
____________________
________
____________ __________________
(B) List courses, workshops, and professional teaching of writing meetings,
memberships, and conferences
you have participated in.
Date:
___________________________________________
_____________________
___________________________________________
_____________________
___________________________________________
_____________________
If necessary and you are selected as a finalist, would you be willing to
come to Western Kentucky University
at your own expense for a personal interview with the Project staff?
Yes______ No______
If you are selected for the Project and decide to participate in our
Outreach program (designed to provide paid
in-service to schools and districts), do you agree to allow the Outreach office
to act as your "booking agent"
and make all arrangements?
Yes______ No______
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