The Dirksen Congressional Center: [Programs] Congress in the Classroom® On-Line Application

Congress in the Classroom® On-Line Application

Greeting

First and Last Name

Nickname (if applicable)

Position

Home Mailing Address

City, State, and Zip

Home Phone

Home E-mail Address

School Name

School Mailing Address

City, State, and Zip

School Phone (including area code)

School E-mail Address

Subjects Taught

Grade Level

Total Number of Students Taught Per Year

Number of Years Teaching

Do you have Internet Access in (check all that apply)
Your Classroom? Your School? At Home?

Have you attended Congress in the Classroom® in the past?
Yes No

Preferred Contact
Home E-mail School E-mail

Why are you interested in attending Congress in the Classroom®? Please use the box below to answer in no more than 200 words.

We are interested in the resources you currently use to teach about Congress. In the box below, describe the lesson plan, Web-based resource, or other activity you use. Please limit your description to 100 words. If you are selected for the program, you may have the opportunity to present your resource or activity to the workshop attendees.