#PEInstitute15

APPLICATION FORM
Please note that we will be accepting applications on a rolling basis. In other
words, we will review and approve individual applications as they are submitted.
Once we hit #12, we will close the application process.
Background: This year, the National Physical Education Institute (#PEInstitute15)
will be offering 12 presentation slots to at large K-12 physical education teachers who
are considering attending the National Physical Education Institute that will take place on
July 27-29, 2015 at UNC Asheville.
Selection Criteria: The following criteria will be used to select the 12 at large
presentation slots 1. Must be actively using resources tied with social media (i.e., Twitter,
Facebook, Google+) to improve instruction;
2. Aligning the written, taught, and tested curriculum in physical education;
3. Evidence and Demonstration of Instructional Technology (i.e., instructional
blog, use of Google Docs, development of PE website, Flipped Classroom);
4. Ability to collaborate and share PE Best Practices with others at the PE
Institute in improving over-all learning for students.
5. Must affirm and practice the following Consortium of Positive Physical
Educators (COPPE) characteristics when presenting a 45-minute breakout
session at the 2015 PE Institute:
All students participants are physically active for at least 50% of the
lesson.
Each lesson has a clear purpose that is explained to the students
(participants) during the start of the lesson/session.
Throughout the session/lesson, students (participants) are provided
with specific, congruent feedback on the skills being taught and
assessed.
All students have their own piece of equipment.
The lesson is developmentally appropriate respecting that students
have different skill levels and abilities.
Breakout Session Duties: Individuals selected will be expected to:
Supply their own presenter technology tools (i.e., laptop). We will provide a
screen, table, extension cord and presenter table.
Bring their own PE equipment if this is feasible or provide a list of PE
equipment that will be provided by our primary sponsor, US Games.
Develop a detailed handout and optional PowerPoint presentation to be
provided by June 1st, 2015. No exceptions!
Serve as on-going National PE Institute Ambassadors to bring about greater
change as Social Entrepreneurs who view physical education as a pressing
cause.
Submission Process: Individuals interested in applying for one of the twelve At-Large
breakout session slots must submit a written application addressing the five Selection
Criteria as seen on the previous page (maximum 3 page limit) along with the attached
Screening Form to:

Artie Kamiya - Artie@greatactivities.net

Questions? Contact Artie Kamiya - Artie@greatactivities.net or 919.818.6486.

2015 National PE Institute Breakout Session

Screening Form
Name:
School Name:
School District:
Work E-mail:
Summer E-mail:
Cell Phone:
Home Phone:
Preferred Mailing
Address:
Please fill-in the following:
Twitter User
Name
Blog URL
* Short Bio
(160 words)

* Session
Title

* Grade
Levels of
Intended
Audience(s)

* Session
Description
.
All
breakout
sessions
will be 45minutes in
length.
* If selected, the short bio, Session Title, Grade Levels, and Session
Description will be used in the PE Institute printed program.
* Also please include a digital head shot for our printed program as well!
This Screening Form must accompany your application (Maximum of 3
pages, 12 point font, double-spaced).

Timeline
Applications are accepted on a rolling basis.
Selected Breakout Session Presenters will be notified by e-mail upon
review and acceptance.
We will no longer accept application once the 12 slots have been filled.
Sorry!

NOTE
We will NOT be able to provide a stipend, travel allowance, or fee waivers
for selected individuals. Sorry
All selected individuals are responsible for planning their travel, lodging,
etc. for this event.
At-Large Breakout Presenters should not be representing PE Institute
vendors or other commercial enterprises. If you have any questions re:
this, please call Artie Kamiya (919.818.6486). In other words, we want to
keep conflicts of interests as a presenter at a minimum.
The decisions of the Screening Board Members are final.
We are sorry for having you jump through the hoops in completing this
application form, but we only have 12 at-large slots this year as each of the
five fantastic keynoters (Joey Feith, Andy Vasily, Nathan Horne, Jarrod
Robinson and Dr. Ash Casey) will also be doing two breakouts at
#PEInstitute15.

2015 National PE Institute Breakout Session

Application Form
Background: Please use the space below to address the five items in the Selection Criteria as
seen on page 1 (maximum 3 page limit, 12 point font, double spaced). We are focused in having
breakout session presenters who have both a strong background in Social Media, using
technology in the classroom, and strong pedagogy skills. Please tell us how your background is a
good fit for this focus. Thanks!
-----------------------------------

Tell us why and how you would be a good fit to be an At-large Breakout Session
Presenter