First Name: Last Name:
School District:
School:
Discipline(s) Taught:
Grade Level(s) Taught:
Number of years of teaching experience:
Are you a Science Olympiad Coach? Yes No
Are you a Young Epidemiology Scholars Competition mentor? Yes No
Have you taken a course in epidemiology? Yes No
Have you taught an epidemiology lesson? Yes No
If so, did you create the epidemiology lesson "from scratch" or adapt itfrom existing epidemiology education materials? From Scratch From Existing
If you adapted the lesson from existing epidemiology education materials, what materials did you use? (Check all that apply.)
Young Epidemiology Scholars Teaching Units CDC's EXCITE CDC's Epidemic Intelligence Service's Case Studies Detectives in the Classroom Exploring Drug Abuse through the Science of Epidemiology Columbia University's Epiville Others:
When the workshop is completed, what do you want to be able to do that you are not able to do now?
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