Celt Application Form / Adams State College

CELT Application Form

CELT Fellows Institute 2008
May 18 – 23, 2008
Sagebrush Inn and Conference Center
Taos, New Mexico

SUBMISSION PROCEDURES: Please submit this CELT Fellows Institute 2008 Application Form no later than March 31, 2008. In addition, please have your department chair or dean submit a letter of support on your behalf by March 31, 2008. The Title V Steering Committee will review all applicants and contact you regarding your selection in the CELT Fellows Institute 2008 by April 14, 2008.

Name

First

Last

Position
Mailing Address
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Email
Phone - (###) - ### ####
Pick Appropriate College
What does your current work involve?

In a short written description please respond to this question.
After reviewing the CELT Fellows Brochure and the Title V Cooperative Grant Brochure indicate how your involvement in CELT Fellows Institute 2008 will support your teaching and/or commitment to academic student success.

In a short written description please respond to this question.
***AFTER SUBMITTING THIS FORM, YOU WILL RECEIVE AN EMAIL CONFIRMATION WITHIN 30 MINUTES***

Title V links

Title V Institutions

Contact Info

Adams State College

208 Edgemont Boulevard
Alamosa, CO 81102

ES Building: Rm 107
Phone: 719-587-7691

asctitlev@adams.edu

Otero Junior College

1802 Colorado Avenue
La Junta, CO 81050

Phone: 719-384-6885

jim.herrell@ojc.edu

Trinidad State Junior College

600 Prospect Street
Trinidad, CO 81082

Phone: 719-846-5697

Shannon Shiveley