Application Form for the Smart Manufacturing Workshop- Motlow State Community College- Smyrna, TN
the workshop will take place on Tuesday July 23rd and Wednesday July 24th, 2019
The workshop is open to instructors of high schools, technical, and community colleges who teach courses in manufacturing or related fields (mechatronics, mechanical, electrical engineering technology, ...etc).

Please enter your official institutional email address:

Email address *
Please enter your full name (First M. Last):
Name: *
Your answer
What type of institutions do you work in?
Institution: *
What is your role in your institution?
Role: *
What courses do you teach in your institution?
List courses that you teach: *
Your answer
Please enter the name of your institution:
Institution name: *
Your answer
In which state and city is your institution located?
Institution State/ Territory *
Please enter the name of the city where your institution is located:
City: *
Your answer
What is the highest academic degree do you hold?
Degree *
Pleae explain how this training workshop would be beneficial to you as an educator? and how do you plan to implement it in your class?
Explanation: *
Your answer
As a requirement of the federal grant, this workshop is only open to U.S. Citizens/Permanent Residents and legal resident aliens, in order to receive the workshop participant stipend.
Are you a U.S. citizen, Permanent Resident, or a legal resident alien? *
Certification and Confirmation: I certify that the information I entered above is correct. I understand that I have to be a teacher/academic instructor at the time of the workshop.
Please type your initials below: *
Your answer
A copy of your responses will be emailed to the address you provided.
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