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ZERO ROBOTICS APPLICATION 2017 MIDDLE SCHOOL SUMMER PROGRAM
Application Instructions
Toapply,pleasecompletethefollowingapplication.Narrativeresponsesshouldbenomorethantwotypedpages.Applicationsmaybesubmittedviae-mailtoEricShawateshaw@massafterschool.org.Applicationssubmittedbye-mailwillreceiveaconfirmationnote.
Forquestionsoradditionalinformation,pleasecontactEricShaw.
COMPLETEDAPPLICATIONSMUSTBERECEIVEDBYWednesday,April19,2017.Applicationsandanyattachmentmustbesubmittedviae-mailtoeshaw@massafterschool.org
with“ZeroRoboticsApplication”inthesubjectline. Eligibility
Anypublicorprivateschoolorcommunity-basedorganizationthatservesmiddleschoolyouthiseligibletoapply.Programsmustserveateamof10-20youthforaminimumof15hoursperweekfor5weeks.
Priorityconsiderationwillbegiventoprogramsthatserveunder-representedorunder-servedpopulations.Eachprogrammusthavecomputersandinternetaccess.
MassachusettsAfterschoolPartnership 128ATremontSt.Suite4f
Boston,MA02108
6173380057 EricShaw
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PART I: Organizational Information Organization Information and
Community Demographics ORGANIZATIONNAME
ADDRESS CITY ZIP
PHONE FAX WEBSITE
Social Media TWITTER
FACEBOOK
INSTAGRAM
OTHER
Pleaseplacean‘X’alongsideallthatapply:
School/Schooldistrict
21stCenturyCommunityLearningCenter
Community-BasedOrganization
Faith-BasedOrganization
Other(pleasedescribe) Contact Information
EXECUTIVEDIRECTORAND/ORPRINCIPAL PHONE EMAIL
PROJECTCOORDINATOR(ifdifferent) PHONE EMAIL
ZeroRoboticsApplication:MiddleSchool2017SummerProgram Page2
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Community Information:
Pleaseindicatethepercentageofstudentsinyourcurrentprogramorschool.
· Gender:Female:______%Male:______% ·
Low-Income(receivingfreeorreducedlunchand/orcontracts/vouchers/subsidies):______%
· Childrenoryouthwithdiagnoseddisabilities:______% ·
EnglishLanguageLearners:______% · Racial/EthnicDemographics
PERCENTAGE Race/Ethnicity
% AmericanIndianorAlaskaNative
% Asian
% BlackorAfricanAmerican
% HispanicorLatino
% NativeHawaiianorPacificIslander
% WhiteorCaucasian
% Other
·
Pleaseidentifyfromtheabovedemographicsthestudentsthatyouwillspecificallytargetfor2017
participationinZeroRoboticsandhowyouwilloutreachtothem:
ZeroRoboticsApplication:MiddleSchool2017SummerProgram Page3
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PART II: Narrative
Pleaserespondtothefollowingquestionsbrieflyandconcisely(nomorethan2typedpages).
Provide a Brief Description of Your Program and Partners
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Doesyourorganization/schoolcurrentlyofferaSTEMcourseand/orcurriculumduringthesummer?
·
Ifyes,pleasedescribeyourSTEMofferings,anyonlineorprintedSTEMcurriculayouhaveused(i.e.NASAK-12onlinecurriculum,FIRST,EiE/EA),andexplainhowtheZeroRoboticsProjectwillcomplementyoursummerlearningprogram.
·
Ifno,pleaseexplainhowandwhyyouwouldliketoaddaSTEMcomponenttoyoursummerprogram
throughZeroRobotics.
·
DescribeanyparticularexperiencewithcomputerprogrammingorteachingSTEMsummercurriculathatyourstaffmembersorvolunteersmayhave.
·
StrongpartnershipsareessentialtoasuccessfulZeroRoboticsprogram.Discusswhichagencies,
organizations,schools,orotherserviceprovidersyouplantocollaboratewithonthisproject.Ifyouhaveacommitmentfromthesepartners,havetheyagreedtoprovidevolunteers,financialsupport,oranotherformofsupport?Ifyouhavenotyetengagedpartners,pleaseexplainwhyand/oryourplantodoso.
·
IfyouhaveparticipatedinZeroRoboticsinthepast,letusknowwhatyouthoughtofit.Shareanysuccess
storiesyoumighthavehad.
ZeroRoboticsApplication:MiddleSchool2017SummerProgram Page4
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PARTIII:RequiredCommitment
Bysigningbelow,youconfirmthatyourprogramagreestoprojectcommitments:
______________________________________________agreestothefollowing:
Organization/Schoolname
·
Myprogramwillserve10-20youthfor5weeksofthesummerforaminimumof15hoursperweek(includingfieldtrips).
·
Myprogramagreestotargetunderservedandunderrepresentedyouthforthis
program.
·
Myprogramhasenoughcomputersforyouthtoaccess,utilize,andlearnonoverthesummer.
·
MyprogramwillidentifyandhireaZeroRoboticsCurriculumCoordinator(also
knownasyourteacher,mentor,orspecificeducatorleadingstudentsthroughthecurriculum)whowillcommittoattendeducatortrainingsessions,coordinatetheZeroRoboticsprogram,andserveasthemainprogramsitecontact.
·
Myprogramwillcoordinatetransportationtoanall-competitorFieldDayinthe
secondweekoftheprogram.
·
Myprogramagreestocoordinatetransportationandauthorization/permissionformsforyouthandfamiliestoattendthefinalISSCompetitioninthemiddleofAugust.
·
MyprogramwillcommunicateregularlywiththestatecoordinatorsandZeroRoboticsteam.
·
Theeducators,mentorsandvolunteersagreetoprovidewrittenfeedbackon
curriculumdesignandeaseofusetotheZeroRoboticsteam.
·
Myprogramagreestohavestudentsandeducatorscompleteallpre-/post-evaluationsinatimelymanner.
· Myprogramwillshareoursummerstorywithlocalnewsoutlets. ·
Ourprogramwillengagefamiliesthroughoutthefive-weekprogram.
· Ourstaffagreestohavefunandlearnalongsideourstudents!
Signed:__________________________________________________Date:____________________
AuthorizedSignature
