STEM CampInterest Form Please complete and submit this form by April 15, 2022. List the session(s) dates that you are available and specify the topic(s) you would like to teach. The sessions will run from 8:30 am to 3:00 pm, with a drink and a snack provided. Each one-day session will provide the same number of hours and instruction time that the week-long sessions provided in previous years. You may choose to teach the same topic sessions one or two different dates throughout the summer. Be sure to indicate if students should possess a preferred ability (such as a higher level of math proficiency). Please include a brief description of each course and indicate if you have a grade level preference (only grades 4-6 only grades 7-8 or no preference). Instructors will receive up to $50 stipend for supplies and compensation for their time! Instructors will earn $260 per class taught (which equals $40 per hour). Preferred class date Topic & description of sessionGrade Level Preference Grades 4-6 Grades 7-8 No preference Class size limit? 10 students 15 students 20 students Unsure Preferred class date (if you opt to teach a 2nd session) Topic & description of additional sessionGrade Level Preference Grades 4-6 Grades 7-8 No preference Class size limit? 10 students 15 students 20 students Unsure Name* First Last Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Daytime Phone*Evening PhoneEmail* Enter Email Confirm Email Questions/Comments?You will receive a confirmation email with additional instructions soon. Thanks for signing up!PhoneThis field is for validation purposes and should be left unchanged.