Martin & Doris Rosen Summer Symposium Scholarship Form | Center for Judaic, Holocaust, & Peace Studies

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Appalachian State University

Martin & Doris Rosen Summer Symposium Scholarship Form

This form is for teachers applying for a scholarship which covers room and board, and two meals a day.

Title:

Mr., Miss, Ms., Mrs., etc.

Name: *

Permanent Address

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City:

State:

Zip Code:

Mailing Address

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Zip Code:

Day Phone:

Night Phone:

Email:

School where you teach

Name:

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Teaching Position / Subject:

Years at this school:

Current Teaching Assignment:

Professional Information:

List any classroom, school-wide or community activities in which you have participated related to Judaism and/or Holocaust Studies. Please include some basic information about the methods you use to teach the Holocaust (i.e the books you have your students read, activities you do, etc.).

Special Circumstances:

Please lsit any dietary or special conditions that we should know.

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