Just in Time Math in the STEM Classroom - One Day Workshop

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.

Participant InformationFirst Name:

Last Name:

Name for Badge:

Name of Institution:

Department:

Position Type (professor, staff)

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 Contact
(If you would like to provide a name and phone number for an emergency contact, please enter it below)

During the workshop, participants will be given 15 minutes: 10 for a mini-lecture that they have prepared before the conference depending on their expertise, according to our guidance and on the role of incidental NP's affecting geo and enviro phenomena, and 5 minutes for discussion/questions after each mini-presentation.

Diet and Mobility Accommodations I prefer vegetarian options

Please describe any other food allergies, preferences, or dietary restrictions that require accommodation at the workshop:

Do you anticipate difficulty walking moderate distances?

yes
no

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.

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