ACM Pedagogic Resources > ACM/FaCE > Projects > Strategies for Internationalizing Undergraduate Psychology > Registration

Workshop Registration

Complete the following form and click on SUBMIT to complete your application. Be sure to hit the SUBMIT button before leaving this page or your information will be lost.

Registration Deadline - March 1, 2011

Contact InformationFirst Name:

Last Name:

Position:

Department:

Institution:

Phone:

Email Address:

Professional InformationSubfield of Psychology (clinical, social, etc.):

Number of years teaching at the college level:

Courses taught (or to be taught) with a significant international component:

Countries outside the US in which you have taught a psychology course (if any) and year (e.g., 2008):

Countries outside the US in which you are considering teaching a psychology course (if any) and year (e.g., 2012):

DemographicsGender:

Male
Female

Citizenship (choose one):

U.S. Citizen
Permanent Resident
Other non-U.S. Citizen

Languages Spoken:

Disability status (select one or more):
None
Hearing Impairment
Visual Impairment
Mobility/Orthopedic Impairment
Other
If Other, please describe.

If there is other information relevant to your registration, please let us know here:

LodgingWe have 18 rooms (17 singles, 1 double) reserved at the Archer House River Inn (opens in a new window) and 6 rooms (4 singles, 2 doubles) reserved at the Carleton Alumni Guest House (opens in a new window), both in Northfield. The two inns are located about three blocks from each other, 3-5 blocks from Carleton, and a mile from St. Olaf. The rooms are available at no cost to faculty from ACM schools outside of Minnesota.

I prefer to stay in a single at the Archer House on June 3.
I prefer to stay in a single at the Carleton Alumni Guest House on June 3.
I prefer to stay in a double at the Archer House on June 3. (Use the box below to list preferred roommate.)
I prefer to stay in a double at the Carleton Alumni Guest House on June 3. (Use the box below to list preferred roommate.)
I will find my own lodging.

Preferred Roommate

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 listserv, 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 workshop series. Attribution for original contributions will be made whenever possible.

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