Expression of interest form for "Fulbright-Cottrell Professional Development Workshop"
This Workshop is POSTPONED to a future date due to the recent coronavirus outbreak. We are keeping this form live and accepting entries so you can express your interest for the rescheduled date and add yourself to our mailing list. This is *not* a registration for the workshop.
Contact info:
cfrohli@ncsu.edu
,
vazquezv@staff.uni-marburg.de
* Required
Email address
*
Your email
Personal Data
Title
*
Choose
Ms
Mrs
Mr
Dr.
Prof.
Other
Last name
*
Your answer
First name
*
Your answer
Preferred name (if other than first name)
Your answer
Affiliation (Institution)
*
Your answer
Department
*
Your answer
Current type of position
*
Your answer
Area of research
*
Your answer
Years after completing PhD
*
Your answer
Tweet about yourself
*
Please introduce yourself and your interests in the workshop with a tweet-like text. This will be distributed with the participant list on site.
Your answer
Practicalities
Date of arrival
MM
/
DD
/
YYYY
Date of departure
MM
/
DD
/
YYYY
Dietary Preferences
Vegan
Vegetarian
Carnivore
Clear selection
Food Allergies?
Your answer
Workshop Dinner?
Will you participate in the workshop dinner on Tuesday?
yes
No
Clear selection
Do you need childcare during the workshop?
*
Complimentary, licensed childcare will be available during workshop hours in support of junior faculty attendees with families. We will get in touch with those in need to organize this.
yes
no
Expectations
What are your expectations for the workshop?
Your answer
Any specific subject you would like to see covered?
Your answer
How did you hear about the workshop?
Your answer
Any additional comments?
Your answer
A copy of your responses will be emailed to the address you provided.
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