Camp Internet District Application

 

We are enrolling in Camp Internet as:

New participants Returning Campers
And will be including:
Teachers Afterschool Program Leaders Librarians Technology/Lab Coordinators

We are enrolling Teachers in the following Camp Internet Online
Expeditions:

Qty Discover the California Channel Islands (suggested for grades 4-9)

Qty Explore the Ancient Southwest (suggested for grades 5-9)

Qty Resdicover America's Original Promise (suggested for grades 7-12)

Qty Explore the Global Garden (suggested for grades K-12)

Qty Discover the California Backcountry (suggested for grades 4-9)

Qty Explore GIS Mapping ( basic GPS/GIS resources are available to all grades
- this track selection is for a higher ed version for 7-12 graders)

Qty READ California (grades 3-12)

Services Ordered
We are ordering the following services and/or products:

I. ONLINE PROGRAM (required for every participating teacher)

We are enrolling teachers in the year round online program, with student activities and online professional development, at the discount rate selected in the following drop down box:

Total online program costs :$

II. Live Teacher Training Workshops (highly recommended for every teacher)

We are enrolling teachers in the 3-day pre-session training workshops at the discounted rate noted in the drop down box below

We will be sending teachers for training at the following dates/locations (no limit on combinations)


Total professional development workshops ordered: $

III. Materials Kits (very important for every teacher and classroom)

We are ordering teaching and learning materials kits at a cost of $250 each, and that will include (qty of each type) GPS units Digital Cameras Video Cameras (one per kit) Language Arts Media Kit

Total cost of materials kits ordered $

Total - all services and products combined: $

Contact Information

District Contact

District Contact's Work Email

Agency Name

Location - Street Address

City State Zip

Contact Phone Contact Fax

URL

Superintendent's Name

Superintendent's Email

We are also interested in particpiating in (select one or more, no addtl cost):

GPS/GIS mapping studies Earth Sciences Center

Western Art and Literature Digital Photography and Video

We are also ordering the following (tax and handling/shipping incl):

GPS unit/s $120 each
Digital Still Camera/s $120 each
Digital Video Camera/s $120 each
Language Arts Media Kit/s (videos, books, cds, hands on materials) $120 each
Other

Payment Method - enrollment and materials fees are due by July 5th unless other arrangements have been made.

I am submitting a purchase order/s for the district's enrollment ( you can provide one PO or seperate for program/materials/training)

Agency issuing PO:

Contact for PO - Name
Phone Fax
PO# PO# PO#
Address
City State Zip

We would like to apply for a RAIN, USDA or BIA School scholarship for
teachers to cover the cost of their .

Names of teachers if known (can be submitted later) and grade levels:

Agreement

This enrollment agreement includes opportunties for live training for our teachers, online programs for students, and optional materials. By enrolling, I agree, on behalf of agency, to pay the program package costs, and will be responsible for any travel or field costs or liabilites. Our teachers and students will observe the Camp Internet Accpetable Use Policies for responsible online activities and we will participate fully to the best of our abilities.

Please print, then submit online, and then sign this application/mail a hard copy to
Camp Internet
1129 State Street A7
Santa Barbara CA 93101
(if you decide later to make changes on this form, do so by hand and send in with signature)

Once the district application is submitted, please have each participating teacher use the individual enrollment form to register.


Signature
Date
Thanks for Enrolling !
Questions? Call 1-800-889-2823, or email explore@campinternet.net