Registration

As a member of NAGT, you are entitled to a discount on the registration for this workshop.

You are logged in to your NAGT account.

Your NAGT membership has lapsed! If you renew now, you will receive the NAGT membership discount for this workshop. Otherwise, please complete the registration form below.

Renew Now to Receive Your Registration Discount

Are you a member of NAGT? You must be logged in to receive your member discount.

If you are not yet a member of NAGT you can join now and receive the member discount. Otherwise, please complete the registration form below.

Registration deadline is January 9th, 2015

For further information, contact Jonathan Tomkin (tomkin AT illinois.edu)

Complete the following form and click on SUBMIT to confirm your registration.

You must complete this form in one sitting; you cannot save a portion and return to fill out the rest later. We'd 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.

Be sure to click SUBMIT when you are done. Remember that you will not be able to alter your registration information via this form once you have submitted it, so please be sure you have completed all fields before submitting.

Participant InformationFirst Name:

Last Name:

Name of Institution:

Department:

Email Address:

Confirm Email Address:

(Please Note: 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.)

Workshop QuestionsIn general, what do you consider to be the characteristics of a strong assignment/activity?

Why are you interested in participating in this workshop? Check all that apply.
Teaching quandary. You hope to figure out a solution to a specific issue you came across in a course.
Research interest. This workshop aligns with your own academic interests.
Pedagogical interest. You have always wanted to teach students this content, set of skills or in this manner.
Colleague suggestion. A colleague recommended the workshop to you.
Community interest. You want to take part in an activity with like-minded colleagues outside of your institution (as well as learn something).
Career development. You want to prepare yourself for the next stage of your career.
Other:
If other, please specify:

In this workshop we will be developing action plans that describe how we plan on changing our courses:

In a couple of paragraphs, describe the current class or activity that you plan to improve, and suggest which parts require change (and perhaps which parts do not!).

In a paragraph, describe how you will evaluate theses changes - how will you know if they have been successful?

Research ReleaseI have read the Description of the Research Project and Implications for Participation (opens in a new window) 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 all aspects of this study EXCEPT those listed in the box below:

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 discussions, 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.

I also accept responsibility to cover any costs incurred should I withdraw from participation in the workshop after January 6. I understand that arrangements have been made on my behalf that have associated real costs (e.g. logistics, materials), and in many cases, my early confirmation has secured a place that has been denied to other interested colleagues. Exceptions will only be made in cases of extreme personal hardship.

Payment

The cost of the workshop is $200 (or $150 for NAGT members). Departments or regional groups of four or more may register as a group for $500. If you are a group leader, you are responsible for your group's registration fee; if you are a group member, skip the remainder of this form and hit Submit Without Payment.

You can make your payment online via credit card or by check.

Show instructions for paying by check

Important: Once you submit your registration and payment, arrangements will be made that have associated real costs even if you later withdraw from the workshop. Refunds will not be given except in cases of extreme personal hardship, at the discretion of the workshop leader.

Pay Online or By Check
If you are a group member, skip the remainder of the form and hit Submit Without Payment. Your group leader will submit payment for the group.

Pay Online
Pay by Check

Registration Fee

$200 - Individual ($150 for NAGT members) -- member discount will be reflected below
$500 - Group Leader

Name Email