Event Registration

Participant InfoFirst Name:

Last Name:

Institution

Campus, if applicable

Department

Email Address:

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Do you have a disability, food allergy, or preference that requires accommodation at the event? If so, please describe:

Registration QuestionsBriefly describe one metacognition and/or active learning strategy you implemented after attending the October 14, 2016, workshop, including what you feel worked well and what you plan to change for future semesters.

Position InformationWhich best describes your position?

Full-time permanent instructor
Full-time temporary instructor
Adjunct instructor at one institution
Adjunct instructor at multiple institutions
Non-instructional position

Other position:

How many years of college teaching experience have you had since graduate school?

0-3 years
3-10 years
More than 10 years

In what fields do you teach? Please check all that apply.
Astronomy
Atmospheric Science, including Meteorology
Earth System Science
Environmental Policy/Studies
Environmental Science
Geography, Human
Geography, Physical
Geology
GIS
Oceanography
Other fields:

Demographics

The following information will be reported only in aggregate.

Gender:

Female
Male
I do not self-identify as either male or female
I prefer not to answer

Ethnicity (choose one):

Hispanic or Latino
Not Hispanic or Latino
I prefer not to answer

Race (select one or more, or leave all boxes blank if you prefer not to answer):
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White

Do you currently have a disability?

No
Yes
I prefer not to answer

Are you a veteran or member of the armed forces?

No
Veteran
Currently serving in armed forces
I prefer not to answer

SAGE 2YC

Faculty as Agents of Change

Event Registration