Scientix Friends Application form (SPWatFCL7)

If you would like to be one of the 30 "friends of Scientix", please fill in the form below.

Scientix will confirm organizations if they have been approved as a friend of Scientix within 3 working days of submitting the form. If approved, the organization will need to provide the full name and email of the teacher to Agueda Gras (agueda.gras AT eun.org) by the end of May.

For the selected teachers, Scientix will cover the flight to/from Brussels, the hotel for the nights of Friday and Saturday, and all meals from Friday night to Sunday lunch included. Local transport, travel to/from airport, and health insurance are at the participants' expenses.

Question Title

* 1. Name of the organization

Question Title

* 2. Type of organization

STEM Teacher training center / institution

STEM Teachers association

Science Education center

University with future teacher training / degrees

Science education research institutions (working directly with teachers)

Other (please specify)

Question Title

* 3. Describe the organization in 3 sentences.

Question Title

* 4. Country where the organization is based

Question Title

* 5. Explain how will the organization select the "awarded" teacher.
Please include information like if it is a competition, a draw, etc. URLs if relevant, etc. If not enough information is provided either the application will be rejected or Scientix might ask for further information.

Question Title

* 6. Information on the representative from the organization submitting the form

Full name

Role in the organization

Question Title

* 7. Please confirm you understand the following terms and conditions

	Yes	No
I understand the teacher must be one of the following (a) a primary school teacher; or (b) a secondary school STEM teacher (STEM = science, technology, engineer, technology or maths -- including Physics, Chemistry, Biology, Geology); or (c) a pre-service teacher following a degree to become either (a) or (b) in the near future.	I understand the teacher must be one of the following (a) a primary school teacher; or (b) a secondary school STEM teacher (STEM = science, technology, engineer, technology or maths -- including Physics, Chemistry, Biology, Geology); or (c) a pre-service teacher following a degree to become either (a) or (b) in the near future. Yes	I understand the teacher must be one of the following (a) a primary school teacher; or (b) a secondary school STEM teacher (STEM = science, technology, engineer, technology or maths -- including Physics, Chemistry, Biology, Geology); or (c) a pre-service teacher following a degree to become either (a) or (b) in the near future. No
I understand the selected teacher cannot be the same that submitted the name of the organization to become a friend of scientix nor part of the governing body of the organization.	I understand the selected teacher cannot be the same that submitted the name of the organization to become a friend of scientix nor part of the governing body of the organization. Yes	I understand the selected teacher cannot be the same that submitted the name of the organization to become a friend of scientix nor part of the governing body of the organization. No
I understand the organization will provide the name and email of the selected teacher and any other needed information to Scientix by the end of May.	I understand the organization will provide the name and email of the selected teacher and any other needed information to Scientix by the end of May. Yes	I understand the organization will provide the name and email of the selected teacher and any other needed information to Scientix by the end of May. No
I understand the organization will not receive any compensation which might influence the selection of the teacher.	I understand the organization will not receive any compensation which might influence the selection of the teacher. Yes	I understand the organization will not receive any compensation which might influence the selection of the teacher. No
I understand the organization is fully responsible for the selection process and Scientix cannot be made accountable for any irregularities in the selection.	I understand the organization is fully responsible for the selection process and Scientix cannot be made accountable for any irregularities in the selection. Yes	I understand the organization is fully responsible for the selection process and Scientix cannot be made accountable for any irregularities in the selection. No

Question Title

* 1. Name of the organization

Question Title

* 2. Type of organization

Question Title

* 3. Describe the organization in 3 sentences.

Question Title

* 4. Country where the organization is based

Question Title

* 5. Explain how will the organization select the "awarded" teacher. Please include information like if it is a competition, a draw, etc. URLs if relevant, etc. If not enough information is provided either the application will be rejected or Scientix might ask for further information.

Question Title

* 6. Information on the representative from the organization submitting the form

Question Title

* 7. Please confirm you understand the following terms and conditions

* 5. Explain how will the organization select the "awarded" teacher.
Please include information like if it is a competition, a draw, etc. URLs if relevant, etc. If not enough information is provided either the application will be rejected or Scientix might ask for further information.