University/College/ Organization*
InstituteTitle*
Instructor(s)*
Content Area(s)*	(Select one) STC Kit-based Inquiry Earth Systems Living Systems Physical Sciences ("Elem IPC") Integrated Math/Science/Tech	STC Inquiry Kits Elementary IPC	Living Systems Earth Systems Integrated M/S
PRINCIPAL CONTACT PERSON for this course:
First name*	MI
Last name*
Title*	(Select primary role) Project/Program Director Project/Program Coordinator Project/Program Supervisor Professor Adjunct Professor Assistant Professor Instructor
Work Phone
FAX
E-mail
Institute URL, if any
Institute Date(s)*	(Example:  June 11 - 15, 2001 --OR-- July 2, 3, 5, 6, 9, 2001  )
Daily Schedule (min of 6 hr/day)*	(Example:  8:15 am - 3:30 pm, including one-hour lunch break)
Room #/Floor
Building Name*
U/C Campus*
Street Address*
Parking Location*
INSTITUTE DETAILS and PARTICIPANT BENEFITS
Credit(s) or Hours Available	What professional development benefits are available?  Explain below.
Gifted/Talented	Does this institute meet G/T requirements? Yes    No  # hours
Target Content Objectives*
Technology Included, if any	Calculators                Probe Ware      Computer Applications Graphing Calculators      Microscopes      Digital Cameras
Other Technology (describe)
Pedagogy to be Used
Brief Insitute Description (100 words maximum)*
Requested Funding	HU-LINC pays $450 per HU-LINC participant who successfully completes the institute.  Additionally, HU-LINC will reimburse the institute for costs timely submitted through paid receipts, up to $250 per teacher for inquiry-based materials, manipulatives, and related resources for classroom implementation in the following academic year. (This does not cover institute-related materials.) Are you requesting New Institute Development Funds from HU-LINC for this offering?   Yes    No
Other Funding	What other sources of funding, if any, will be used for this institute? (source and $ amount)
Participant Stipends	HU-LINC provides $300 stipend per institute  for each teacher-participant who attends all sessions (min. 30 hours).  If your funding provides additional stipend/benefits for participants, please describe below:
Institute Description	Please FAX or e-mail your institute description to: FAX 713-892-7126 or e-mail:  jdutcher@houstonisd.org
VITAE	Please FAX or e-mail your Vitae to: FAX 713-892-7126 or e-mail:  jdutcher@houstonisd.org
NOTE:  The principal contact person will be notified within one week following the deadline (shown at top) if this proposal has been accepted.  For questions, please contact Joyce Dutcher via e-mail at: jdutcher @houstonisd.org or call the HU-LINC office at 713-892-6915.