For further information, contact Blair Schneider: blair.schneider@ku.edu
You must complete this form in one sitting; you cannot save a portion and return to fill out the rest later.
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.
If you would like to request travel support to attend the workshop, please complete the travel grant application ↗ in addition to the registration. Participant InformationFirst Name: Last Name: Name of Institution: Department: Name for Badge: Pronouns for Badge: 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.)Cell Phone Number (this information is only used to contact you if there are issues that arise during your transit to or from the workshop): Emergency ContactFull Name: Relationship: Contact Phone: Registration QuestionsThe following questions are designed to help the ADVANCEGeo team gain understanding about your level of experience with facilitating workshops and the workshop content. We will strive to provide the highest quality training for you and your detailed responses to these items will help us. Position title and/or description Have you ever attended an ADVANCEGeo workshop? Yes No If yes, do you remember approximately when or where the workshop was held? In your opinion, what was the most effective aspect of the workshop? Are you familiar with the ADVANCEGeo resources website? Yes No If yes, what do you find most helpful about the resources website? The list below provides topics that are relevant to the ADVANCEGeo workshops. First, we would like to know your level of experience or exposure to the following topics. Consider if you have participated in formal or informal trainings or spent time independently researching the topics. Second, if you were the facilitator of a workshop about that topic what would be your level of comfort or confidence in discussing that topic? Prevalence or recognition of bullying or harassment Level of experience or exposure None at all Some A good amount Level of comfort or confidence None at all Some A good amount Sexual and gender based harassment Level of experience or exposure None at all Some A good amount Level of comfort or confidence None at all Some A good amount Bystander intervention techniques Level of experience or exposure None at all Some A good amount Level of comfort or confidence None at all Some A good amount Intersections of privilege, power and identity Level of experience or exposure None at all Some A good amount Level of comfort or confidence None at all Some A good amount Utility of codes of conduct Level of experience or exposure None at all Some A good amount Level of comfort or confidence None at all Some A good amount Fostering a positive workplace climate or culture Level of experience or exposure None at all Some A good amount Level of comfort or confidence None at all Some A good amount Implicit bias Level of experience or exposure None at all Some A good amount Level of comfort or confidence None at all Some A good amount Microaggressions Level of experience or exposure None at all Some A good amount Level of comfort or confidence None at all Some A good amount Related training topic (please describe): Level of experience or exposure None at all Some A good amount Level of comfort or confidence None at all Some A good amount What areas related to content knowledge would you like the most support with? What areas related to content knowledge will you need less support? The list below provides topics that are relevant to workshop facilitation skills. Please let us know your level of experience and level of comfort or confidence. Organizing and scheduling workshops Level of experience None at all Some A good amount Level of comfort or confidence None at all Some A good amount Tailoring content for a specific audience Level of experience None at all Some A good amount Level of comfort or confidence None at all Some A good amount Upholding established ground rules for participants Level of experience None at all Some A good amount Level of comfort or confidence None at all Some A good amount Facilitating large group discussions Level of experience None at all Some A good amount Level of comfort or confidence None at all Some A good amount Facilitating small group discussions Level of experience None at all Some A good amount Level of comfort or confidence None at all Some A good amount Dealing with resistance from participants Level of experience None at all Some A good amount Level of comfort or confidence None at all Some A good amount Dealing with conflict or discomfort between participants Level of experience None at all Some A good amount Level of comfort or confidence None at all Some A good amount Administering a post-workshop evaluation survey Level of experience None at all Some A good amount Level of comfort or confidence None at all Some A good amount Utilizing evaluation findings to improve the next workshop Level of experience None at all Some A good amount Level of comfort or confidence None at all Some A good amount Related facilitation topic: (please describe) Level of experience None at all Some A good amount Level of comfort or confidence None at all Some A good amount What areas related to workshop facilitation will you need the most support? What areas related to workshop facilitation will you need less support? Diet and Mobility Accommodations I prefer vegetarian options I prefer vegan options I prefer gluten-free options I prefer lactose-free options Please describe any other food allergies, preferences, or dietary restrictions that require accommodation at the workshop: The ADVANCEGeo Partnership is committed to providing universal access to our programming and supporting special accommodation requests to the best of our ability. Please check the box below if you would like a member of the team to follow up with you to assist with accommodations that support your needs (e.g. accessible parking space, alternative formats, lactation room). Advance notice is necessary to arrange accommodation requests. Please have a team member follow up with me. Image ReleaseWe believe that showcasing the individuals who make ADVANCEGeo a success engaged in the work together is a critical part of increasing the reach and impact of the project. To that end, we will be taking photographs of participants in action during the Train the Trainers. We use photos like these to enhance the quality of our website and print publications as well as project documentation for NSF and the ADVANCEGeo community. As a participant, you have the right to opt out of having your photograph taken by project staff at the event. We'll make our best effort to avoid capturing your image in photos we take at the event. If we inadvertently capture your image in a photo that gets posted on the website, please let us know so that we can remove it promptly. Note, this opt out does not apply to photos that might be taken and used by others who attend the workshop. Individuals who have opted out should endeavor to alert photographers should they see someone in their vicinity taking pictures, so that they are not accidentally captured in crowd shots. I agree that still photos may be used on the project website, in printed project publications, and in materials developed by the project: * required Yes No Code of ConductAll participants are expected to read and abide by the ADVANCEGeo Code of Conduct ↗ I have read and agree to abide by the code of conduct * required Workshop Product and Research ReleaseThis workshop is part of an NSF-funded study (#1725879) and will result in the development of materials for future workshops, reports, and other project products. In confirming my participation in the workshop, I agree that my contributions to creative works that emerge from project activities (e.g., discussions on the email list, contributions to the web page, summaries of group discussion, etc.) may be used for development of future workshop materials, for scholarly reports, and other project products. 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 November 15. 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. Name Email
The following questions are designed to help the ADVANCEGeo team gain understanding about your level of experience with facilitating workshops and the workshop content. We will strive to provide the highest quality training for you and your detailed responses to these items will help us.
The list below provides topics that are relevant to the ADVANCEGeo workshops.
First, we would like to know your level of experience or exposure to the following topics. Consider if you have participated in formal or informal trainings or spent time independently researching the topics.
Second, if you were the facilitator of a workshop about that topic what would be your level of comfort or confidence in discussing that topic?
Level of experience or exposure None at all Some A good amount Level of comfort or confidence None at all Some A good amount
Level of experience or exposure
Level of experience
Please have a team member follow up with me.
We believe that showcasing the individuals who make ADVANCEGeo a success engaged in the work together is a critical part of increasing the reach and impact of the project. To that end, we will be taking photographs of participants in action during the Train the Trainers. We use photos like these to enhance the quality of our website and print publications as well as project documentation for NSF and the ADVANCEGeo community.
As a participant, you have the right to opt out of having your photograph taken by project staff at the event. We'll make our best effort to avoid capturing your image in photos we take at the event. If we inadvertently capture your image in a photo that gets posted on the website, please let us know so that we can remove it promptly.
Note, this opt out does not apply to photos that might be taken and used by others who attend the workshop. Individuals who have opted out should endeavor to alert photographers should they see someone in their vicinity taking pictures, so that they are not accidentally captured in crowd shots.
I have read and agree to abide by the code of conduct * required
This workshop is part of an NSF-funded study (#1725879) and will result in the development of materials for future workshops, reports, and other project products.
In confirming my participation in the workshop, I agree that my contributions to creative works that emerge from project activities (e.g., discussions on the email list, contributions to the web page, summaries of group discussion, etc.) may be used for development of future workshop materials, for scholarly reports, and other project products. Attribution for original contributions will be made whenever possible.
