ACM Pedagogic Resources > ACM/FaCE > Projects > Integrating Sustainability into the Undergraduate Curriculum > 2011 Sustainability Conference > Registration

Workshop Registration Form

Registration deadline: March 25, 2011

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.

Be sure to check the Workshop Website (opens in a new window) for more information about the workshop as preparations continue.

Contact Information
First Name:

Last Name:

Department:

Institution:

Address:

City:

Select a State:

Zip Code:

Phone:

FAX:

Email Address:

Confirm Email Address:

Please Note: Your email address is what we use to track your 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.

Logistics

Lodging

Participants will be responsible for their own housing during the workshop. Information on housing options will be posted on the Workshop Website (opens in a new window) as it becomes available.

Special Needs

Do you have a disability, food allergy, or preference that requires accommodation at the workshop? If so, please describe:

Other Questions Several parts of the workshop will involve working with the website. Please check here if you cannot bring a laptop computer with you to the workshop.

If there is other information relevant to your participation in the workshop, please let us know here:

DemographicsGender:

Male
Female

Ethnicity (choose one):

Hispanic or Latino
Not Hispanic or Latino

Race (select one or more):
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White

Workshop Product ReleaseIn 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 email list, contributions to the web page, summaries of group discussion, etc.) may be used by the conveners for development of future workshop materials, for scholarly reports, and for promotion of the project. Attribution for original contributions will be made whenever possible.

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