Registration

Registration Deadline: April 6, 2012

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.

First Name:

Last Name:

Department:

Institution:

Select a State:

Email Address:

Confirm Email Address:

(Please Note: Your email address is what we use to track your application and participation in the webinar. Be sure to use the same email address in all forms relating to your webinar participation. This email will also be our primary means of communication with you.)

Number of years of full-time teaching experience:

Current position:

Which of the following best describes the department or program in which you will teach next fall:

Two year college (Associate is the highest degree)
Private four-year primarily undergraduate (BS or BA is the highest degree)
Public four-year primarily undergraduate (BS or BA is the highest degree)
Masters granting (MS is the highest degree)
Doctoral granting (PhD is the highest degree)

Product Release

In confirming my registration for this seminar, I agree that my contributions to creative works that emerge from seminar activities (e.g., discussions on the listserv, contributions to the web page, summaries of group discussion, etc.) may be used by the program, PIs, and conveners for development of future workshop materials, for scholarly reports, and for promotion of the program. Attribution for original contributions will be made whenever possible.

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