Application

The Mellon foundation, through the Associated Colleges of the Midwest, provides funding for the operational costs of the workshop plus room, board, and workshop materials for the participants. To be supported by these funds, you must be nominated by a dean at your ACM institution. If you don't meet these requirements and are interested in participating in the workshop at your own expense, please contact the workshop conveners.

If you are nominated for the workshop, you will be asked to complete a registration form to provide us with more information.

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. 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. This gives you access to conveniences like spell checking as well as the opportunity to save and reflect on your work before submitting.

Contact InformationFirst Name:

Last Name:

Department:

Institution:

Address:

City:

Select a State

Zip Code:

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. Please double-check that you have typed it correctly.)

Question SetFor housing, faculty will room with other faculty while students will be housed with other students of the same sex. If you have any special housing needs, please describe them:

Please list any food allergies or dietary restrictions that we should know about in planning Workshop meals:

Please describe briefly your interest in participating in this Workshop:

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

If you and/or participants from your campus require travel assistance funds, please contact Andrew Civettini immediately.

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