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FACULTY MEMBERS

If you are a faculty or teacher and would like to participate in the Students for Science and Reason Program, please fill out the form below.

Educators can serve as SSR representatives at their campus, as advisors to local student groups or simply provide their support in our efforts by joining our membership.

Educators may also be interested in helping create educational materials and outreach programs, developing curriculum material and resources, participating in events and activities and also providing their services and expertise to the CSICOP Speakers Bureau.

NAME:

E-MAIL:

SCHOOL:

ADDRESS:

INTERESTS:

SSR REPRESENTATIVE

SSR ADVISOR

SPEAKER

OTHER

IF OTHER, PLEASE SPECIFY:

ADDITIONAL COMMENTS:

         

 


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