On the Cutting Edge - Professional Development for Geoscience Faculty
Student Motivations and Attitudes: The Role of the Affective Domain in Geoscience Learning
Mesa, AZ Workshop 09
> Registration Form
Workshop Registration Form
Registration deadline: August 28,2009
Complete the following form and click on SUBMIT to confirm your registration. Be sure to hit the SUBMIT button before leaving this page or your information will be lost.
We encourage you to compose your answers to the longer questions in a word processor and to cut and paste the resulting text into this form.
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Confirm Email Address:
Your email address is what we use to track your application and participation in the workshop. Be sure to use the same email address in all forms relating to your workshop participation. This email will also be our primary means of communication with you.)
How do you currently use components of the affective domain (addressing attitudes, emotions, motivations, goal setting, and so on) within your introductory geoscience classroom?
What would you like to gain from this workshop?
Briefly describe the activity or course you plan to revise during this workshop.
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Race (select one or more):
American Indian or Alaska Native
Black or African American
Native Hawaiian or Other Pacific Islander
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Other non-U.S. Citizen
Number of years of full-time teaching experience:
Number of years teaching at the college level:
Will you teach next fall at an institution that serves a large number of minority students?:
Which of the following best describes the
department or program
in which you will teach next fall:
Two year college (Associate is the highest degree)
Private four-year primarily undergraduate (BS or BA is the highest degree)
Public four-year primarily undergraduate (BS or BA is the highest degree)
Masters granting (MS is the highest degree)
Doctoral granting (PhD is the highest degree)
How did you learn about this workshop?
browsing the Internet
link from the Cutting Edge web site
word of mouth
If there is other information relevant to your application, please let us know here:
Do you have a disability, food allergy, or preference that requires accommodation at the workshop?
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I have read the
Description of the Research Project and Implications for Participation
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or it was read to me. I know the possible risks and benefits. I know that being in this study is voluntary. I choose to be in this study. I know that I can withdraw at any time. I am at least 18 years of age and voluntarily grant permission for the described release and use of notes and comments regarding me in the workshop.
Please select one of the following choices to indicate your level of desired participation in the study:
I consent to participate in ALL aspects of this study.
My pre-workshop information, all workshop information, and follow-on workshop information can be used in this study, and I agree to participate in a follow-up interview in approximately 2-6 months which will be audio taped. Video, still images, and audio collected at the workshop may also be used in the research project.
I consent to participate in some, but not all, aspects of this study.
Please discuss with us the aspects in which you do NOT consent to participate.
Workshop Product Release
In confirming my registration for this workshop, I agree that any audio recording or images (still or video) made of me during the workshop may be used on the project website, in printed project publications, and in materials developed by the project. I further agree that my contributions to creative works that emerge from workshop activities (e.g., discussions on the listserv, contributions to the web page, summaries of group discussion, etc.) may be used by the workshop series, PIs, and conveners for development of future workshop materials, for scholarly reports, and for promotion of the workshop series. Attribution for original contributions will be made whenever possible.
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Mesa, AZ Workshop 09
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Last Modified: August 14, 2012
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