Participant registration form
DEADLINE: April 3, 2023

Thank you for your interest in our Inspiring Innovation workshop!  We have designed 5 days of sessions that will examine high impact work done in the classroom, across campuses, and within the geoscience discipline at a national scale all with a focus on student success and faculty professional development. Once we've inspired you, we will explore how to take your ideas and make them happen - with funding! 

We invite you to register for the workshop keeping the following in mind:
1) We are asking for your intentional commitment to participate all 5 days of the workshop.  
2) You will get the most out of the experience if you commit to doing the pre-workshop readings for each day.

We absolutely understand you may need to step out to teach a class or attend a meeting; you are still welcome to register for the workshop.  

If registration numbers are exceedingly high, priority will be given to those without prior SAGE 2YC experiences. 
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First name *
Last name *
Email *
Confirm email (this is our primary way of contacting you so we want to be sure we the correct address!) *
Institution (If your institution has multiple campuses, please list your primary location) *
State
What do you hope to gain from this workshop? *
How will you share what you learn at this workshop with your colleagues? *
Which best describes your position? *
What is your primary discipline? (e.g., biology, geoscience) *
Gender *
Ethnicity *
Race  (select one or more) *
Required

Are you a veteran or member of the armed forces?

 *

Do you have a disability that requires an accommodation? If so, please provide us information necessary so we can best assist you.


Workshop Product Release: 
1) In confirming my registration for this workshop, I AGREE that any audio recording made of me during the workshop may be used on the project website, in printed project publications, and in materials developed by the project.

2) I further agree/disagree that any still or recording images of me, and 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 discussion, 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. (Please check yes or no to accept or decline this statement.)
 *
Yes
No
Still image
Video recording
Creative contributions
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