Northern California Application Form 2021

Please note that your application will not be reviewed until you click submit at the end of this form.

Contact information:

Full Name*

First Last

Home address*

Street Address Address Line 2 City State ZIP Code

Home email*

Enter Email Confirm Email

Home phone*

Cell phone*

Name of District*

Name of School*

School Email*

Enter Email Confirm Email

Preferred email*

Home
School

Where did you hear about the seminar?*

Teaching Context

How many years have you been teaching?*

What subjects or courses do you generally teach? (Please specify by grade level)*

Note: Teachers from ALL subject areas are welcome!

How do you currently include teaching about the Holocaust, civil rights or human rights in your teaching?*

Personal Statement

An opening statement: We don’t expect you to be an expert in Holocaust scholarship or pedagogy prior to attending the seminar. However, we would like your answers to these questions to convey a sense of what you hope to achieve, what knowledge, background, or perspective you bring, and what defines you as an educator.

Describe the context in which you teach and the social justice issues that shape your students’ lives both in and outside of school.*

What area of social justice do you see as a critical need in your community? Please briefly explain.*

What draws you to the topic of Holocaust/Human Rights/Social Justice education?*

What do you hope to accomplish as a result of attending the seminar?*

In order to reserve your spot for the Satellite Seminar, TOLI requests a valid credit card number for a good faith deposit of $50. Card numbers will be entered via a secure website portal. Your credit card will only be charged if you cancel two weeks or less prior to the start of the seminar or if you withdraw without notice. The charge serves as reimbursement for books and resource materials ordered on your behalf.

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Good Faith Deposit

Good Faith Deposit

Credit Card

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PLEASE CONTACT THE SATELLITE LEADERS WITH ANY QUESTIONS YOU MAY HAVE. When your application is accepted, satellite leaders will ask you to send an email reply which will serve as a letter of your intent to attend the seminar.