Environmental Learning Institute & Woodrow Wilson National Fellowship Foundation 2005 TORCH Environmental Learning Institute Phone: 520-245-3711 FAX: 480-275-3318; E-mail: silverberg@alum.mit.edu How to apply: 1. Complete the Application Form. Give the Reference Form to a supervisor (e.g. principal, dean, manager) who is well acquainted with you and your teaching. Please submit the Application and Reference Form. We encourage you to email these forms back to us. It saves paper, energy and postage. You can copy the forms from your browser and paste them into WORD. If necessary, please FAX completed forms to: 480-275-3318. You will be notified of your acceptance within a few weeks. We have a rolling admissions policy. 2. If financial assistance is required in order to attend the course please complete the TORCH Educator Partial Fellowship Application and include this with your application and reference form.
Title: Dates: Will you be participating in the course for credit and what type of credit will you register for? Additional fees are required for credit. (graduate-level relicensure hours or graduate science hours; please circle) PERSONAL INFORMATION Name: Date of Birth: Social Security #:
Street: Permanent Address Street: School: Passport Information Education College/University Name: Additional Information Experience and Interests Extracurricular activities/clubs or organizations: Please briefly (not more than a few paragraphs, attach additional page) explain what your learning objectives are by participating in this TORCH course. I have read the WWNFF-sponsored/Environmental Learning Institute TORCH course description, syllabus, proposed itinerary, personal equipment list, personal clothing list, medical form, liability waiver. I feel that I understand and would enjoy and benefit from the academic and professional development experience they describe. I certify that all information I have provided on this form and in the other required forms are correct and accurate to the best of my knowledge.
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