Form PC-2042 Correspondence Match Enrollment Form

Correspondence Match Educator Enrollment Form

93556 CM Brochure_enroll_form

Correspondence Match Educator Enrollment Form and Teacher Survey

OMB: 0420-0513

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Join the Correspondence Match Program

L

ink up with a Peace Corps
Volunteer working overseas at the
grassroots level who will correspond
with your students!
Whatever your grade level, area of
expertise, or geographic preference,
there is a Peace Corps Volunteer who
is ready to share stories, artifacts,
photos, and more with your students.
Some classrooms write a letter every
few months; others correspond through
weekly e-mails. All classrooms can
augment the Volunteer experience with
our award-winning, standards-based
materials.

The possibilities are as vast as you
want to make them. The cost is as
little as a postage stamp—or less.

Correspondence Match Fast Facts
The Correspondence Match program
was established in 1989 to help
Americans better understand other
peoples.
Since the program began, nearly
3 million U.S. students have
communicated directly with Peace
Corps Volunteers throughout the
world.

Teachers in many subject areas are
benefiting from the Correspondence
Match program:
Social studies
Language arts
Math
Art
Health

Foreign language
Science
Service learning
Environment

Three thousand Peace Corps
Volunteers are relating their
experiences through Correspondence
Match today.

www.peacecorps.gov/wws/correspond

Stay Connected Through World Wise Schools
Here’s what you’ll receive as an enrolled educator:
Match Handbook—Ideas and examples
for starting and sustaining a successful
match with your Peace Corps Volunteer

New Coverdell World Wise Schools
publications—Available at no cost to
your classroom

Monthly e-newsletter—The hottest
online cross-cultural resources, with
a timely theme for each month of the
school year

Overseas phone calls—A chance to
participate in an agency-sponsored
call to your overseas Volunteer during
Peace Corps Week, which occurs
every year around March 1

Peace Corps calendar—A year full of
colorful photographs and facts from
around the world

“The program has allowed my students
to learn so much more about other
cultures than they could just from a
textbook.”
— North Carolina Teacher

Invite a returned Peace Corps Volunteer to speak to your classroom!
Speakers Match—We can connect you with returned Volunteers in your area.
Many classrooms host their own Correspondence Match Volunteers after the end
of their service. Visit www.peacecorps.gov/wws/speakersmatch for details.

Contact Us
Peace Corps Headquarters
Office of Domestic Programs
1111 20th Street NW, 2nd Floor
Washington, DC 20526

E-mail: [email protected]
Tel: 800.424.8580, ext. 1450
Fax: 202.692.1421

Correspondence Match Enrollment Form
Name
School
Address
	
City	 	

	

	

	

State	 	

ZIP	

School phone		

	

	

Home phone

Primary e-mail
Grade 		

Subject 	

	

	

Number of students

Signature	

	

	

	

	

	

	

Date

If you know a Volunteer with whom you would like to correspond, please indicate:
Name					

Country of service

Geographic preference
Choose three areas and rank them in order of preference. Your first choice
may not be available due to geographic distribution of Volunteers.
Africa
Mediterranean/Eastern
Europe/Central Asia
Central/South America

East Asia/Pacific Islands
French Speaking		
Spanish Speaking
No preference

Optional questions
Please enter A, B, C, or D from the scale below to indicate the makeup of your
student body. By answering these optional questions, you will help World Wise
Schools reach its goal of bringing global education to a diverse population.
A: Under 10%

B: 11%–25%

C: 26%–50%

American Indian or Alaska Native
Asian or Pacific Islander
Black (Not of Hispanic origin)

May we quote you in our materials?	

Please describe your
school: (check all that
apply)

D: Over 50%

Hispanic
White (Not of Hispanic origin)
Other

Yes	

No








Public
Private
Parochial
Home
Charter
Not a 	
school

Periodically, we receive requests for information from the media, Congress, returned Volunteer groups,
or educational institutions. May we release information about you (name, school, and school address
only) to these groups?		
Yes	
No

www.peacecorps.gov/wws/correspond
[email protected] (tel) 800.424.8580, ext. 1450 (fax) 202.692.1421
The Peace Corps Act (22 USC § 2501 et seq.) authorizes this collection of information. It will be used to enroll educators in the Coverdell World Wise Schools Correspondence
Match program for the purpose of promoting a better understanding of other peoples and cultures in U.S. classrooms. Information provided will be recorded by the Peace
Corps and, when permitted by the educator, may be shared with the media, Congress, returned Volunteer groups, educational institutions, and other government agencies.
Providing the information herein requested is voluntary. The Peace Corps may not conduct or sponsor, and a person is not required to respond to, a collection of information
unless it displays a currently valid OMB control number. The time required to complete this information collection is estimated to average 10 minutes per response,
including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of
information. Send comments on this form to Peace Corps, Office of Domestic Programs, Coverdell World Wise Schools, 1111 20th Street, NW, Washington, DC 20526.
OMB control number: 0420-0513. Continuous use form. Feel free to make copies of this form to share with your colleagues.

PC-2042 (Rev 05/2007) (Other versions of this form are obsolete.)

Paul D. Coverdell Peace Corps Headquarters
Office of Domestic Programs

Connect Your Classroom
With a Peace Corps Volunteer


File Typeapplication/pdf
File Modified2007-12-03
File Created2007-05-16

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