Noyce Master Teacher Fellowship (MTF) @ UCSD
Annual Participation Form Worksheet
Please complete the information below. This document is used for participation as defined by the
Noyce MTF @ UCSD program and the NSF/Noyce Foundation. This worksheet can serve as a
record for you to keep as well as a way to track your responses to the online form.
Program Overview
UCSD was awarded the Robert Noyce Master Teacher Fellowship grant through the National Science Foundation
(NSF 1136369) in October 2011. This program is designed to give teachers the skills, commitment, and professional
support they need to continue teaching in urban schools. The program is a partnership between the Division of
Physical Sciences, UCSD CalTeach Education minor, and the Department of Education Studies. The overarching
goal of this program is to provide local mathematics and science teachers with the training, support, and professional
development to be educational leaders within their schools and school district. We want to support strong leadership
and pedagogy within high-needs urban schools.
Program Requirements:
 Teach for 5 years in a high-needs school district as defined by the MTF program.
See http://edsserver.ucsd.edu/noyce/ for details on requirements and qualified districts.
 Regularly participate in online professional network group.
 Mentor STEM majors who express an interest in secondary education.
 Participate in formal online learning courses.
 Attend MTF sponsored conferences and professional growth activities.
Participant Information
Name:
School Site:
District:
Mark
for
“yes”
I certify that the school district in which I am employed meets at least one of the three “highneeds” eligibility criteria as defined by the Noyce MTF @ UCSD program.
Online Professional Group Interaction
The program expects that participants will interact with the online professional group on a
regular basis. Currently MTF uses Facebook groups for this forum.
Please mark all your interactions that apply.
Check the group page on a regular (daily or weekly) basis.
Post questions or share resources with the group.
Comment on the posts of other participants.
Use the events page to keep up to date with professional learning opportunities.
Engage with other participants in discussions.
Send direct messages to other participants in the group.
Use the group page to network with other professionals in my field.
I have not been able to engage in the online community.
Mentoring Experiences
Noyce Master Teacher Fellowship (MTF) @ UCSD
Annual Participation Form Worksheet
One of the powerful learning opportunities of the program is the mentoring of others. We offer ways to mentor
CalTeach students, classroom tutors, apprentice teachers, student teachers, Intern teachers, community
college students, and MSED & Ed.D candidates. Please list your mentoring experiences below.
Mentee’s Name
Mentee Status
Dates of Mentoring
(tutor, student teacher, etc.)
Online Courses
Mark
for
“yes”
I have completed the Online Mentor Training course.
Please list the formal online training courses in which you have participated.
Course Title
Course Dates
Conferences
Please list any conferences, workshops, and professional activities that you have attended in connection with the
MTF program.
Conference/Activity
Dates Attended
Other Professional Activities
Please list any other professional activities that have benefited you as a participant in the Noyce MTF program.
Please keep this worksheet for your records.