Martin & Doris Rosen Summer Symposium Scholarship Form

Registration opens January 10, 2022

This form is for teachers applying for a scholarship which -- for in-person participants -- covers room and board, and three meals a day in addition to books and teaching materials. For virtual participants the scholarship provides books and teaching materials along with access to all symposium sessions (including restricted teacher workshops).

Title

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

Name *

Mailing Address

Street

City

State

ZIP Code

Permanent Address

Street

City

State

ZIP Code

Day Phone

Night Phone

School where you teach

Name

Street

City

State

ZIP Code

Teaching Position including ages taught / 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.).

Why do want to participate in the symposium and what do you hope to gain from your participation?

Special Circumstances

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

In the last 5 years, have you been awarded a Martin & Doris Rosen Scholarship:

Planned dates and form (in-person or virtual) of attendance:

Leave this field blank

Center for Judaic, Holocaust, and Peace Studies

Martin & Doris Rosen Summer Symposium Scholarship Form