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 Email 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 Submit