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.



PAGE 1                                                                                          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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