Teaching Innovations Program (TIP) --- Workshop Application

I would like to apply for the following workshop:

Hotel Santa Fe, Santa Fe, New Mexico - June 5-7, 2009

Chicago Marriott Suites O’Hare, Rosemont, Illinois - June 12-14, 2009

The application for a TIP Workshop is a three-part process.

Part I is submitting information about yourself and your department. Submitting this electronic application form will complete Part I and enable us to start your file.

Part II is securing a letter of support from your department chair (or university administrator) e-mailed to tipecon@unlnotes.unl.edu (see details below).

Part III is sending a check via regular mail for the participation fee of $100.00 (see details below). This participation fee will be refunded if the application is not accepted.

Part I Personal Information

First Name:

Last Name:

Gender:

Male

Female

E-mail Address:

Street Address:

Apt #/PO Box

City

US State or Canadian Province:

Zip

Telephone:

University Information

University Name:

Department:

Street Address:

City

US State or Canadian Province

Zip:

Telephone:

What is the highest degree offered by your department?

Bachelors

Masters

PhD

Education, Teaching, and Other Information

Have you completed your Ph.D?

Yes

In what year did you receive or do you expect to receive your Ph.D?

Name of Ph.D. Granting Institution:

Job Title:

Assistant Professor

Associate Professor

Full Professor

Other

How many years have you been in your current position?

What is your tenure status?

Tenured

On tenure track but not tenured

Not on tenure track

Other

Please Describe Other Tenure Status:

In 100 words or less describe the course(s) that you will teach in which you plan to introduce interactive teaching and learning strategies.

List the economics course(s) in which you plan to apply interactive learning strategies.

Course I:

Course I- Undergraduate:

Yes

Course I - Graduate:

Yes

Course II:

Course II- Undergraduate:

Yes

Course II - Graduate

Yes

Course III:

Course III - Undergraduate

Yes

Course III - Graduate

Yes

Travel Subsidy for Minority Participants

A limited amount of funds are available from the NSF grant for travel subsidies for faculty members employed by a DOE minority institution. Please note that this subsidy will be paid to eligible participants after submission of dated receipts for normal travel expenses such as airfare and ground transportation.

Are you employed by a DOE minority institution?

Yes

Do you wish to apply for a travel subsidy?

Yes

State the amount of subsidy you are requesting:

Part II Have a letter of support e-mailed to tipecon@unlnotes.unl.edu

Have your department chair (or university administrator) write and e-mail a letter of support for your participation in this workshop with the chair or administrator's title, address, and other contact information given in the e-mail. Have him or her state the likely benefits to you, your students and your department or university. The e-mail letter should be sent to tipecon@unlnotes.unl.edu with the subject line "TIP: First Name Last Name" of workshop applicant.

From whom did you request this letter?

E-mail address of person providing letter of support:

Part III Mail $100.00 check payable to University of Nebraska-Lincoln.

Please send a check (made payable to the University of Nebraska-Lincoln) to: Professor William Walstad, Department of Economics, 339 College of Business Administration, University of Nebraska, Lincoln, NE 68588-0402. This check is a participation fee and will be refunded if the application is not accepted.

We treat applications as incomplete until we receive the check. We will refund the fee if we do not accept you or if you withdraw before March 1, 2009. If you withdraw after March 1, you forfeit the fee.

Applications are not considered complete until the check is received.

Consent

An evaluation of TIP will be conducted using the information that you supply in this application, and in follow-up surveys. Precautions will be taken to avoid the disclosure of personal information in any research report that is generated using these data. Your employer will not have access to the data you provide.

Do you consent to have the information in this application used in this National Science Foundation-supported program and in future research conducted under TIP auspices?

Yes

Do you consent to participate in follow-up surveys related to this TIP program?

Yes

Address Information of Contact Person

Please give the name, address, phone number and e-mail (if applicable) of a contact person who can be counted on to know your location in two years time (this person will only be contacted in the event that we cannot locate you at your old address or via web search):

Contact Name:

Street Address

Apt #/PO Box

City

US State or Canadian Province

Zip

Phone number

E-mail Address

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