Name _________________________________________________________________
Department ____________________________________________________________
Institution ______________________________________________________________
Institution address
________________________________________________________
________________________________________________________
Email _____________________ Telephone ______________________
The following information will help us in planning workshop activities.
Disciplinary Areas: _________________________________________________________________
Do you have any prior experience with PBL? _______ If so, please comment: _________
FEES: The registration fee for the conference is $250 which includes workshop materials and refreshment breaks. Participants assume responsibility for living accommodation, meals, and transportation. Please make checks payable to the University of Delaware.
Please return this form with payment to:
ITUE January Intro to PBL 2012 c/o Susan Groh
Department of Chemistry and Biochemistry
University of Delaware Newark, DE 19716.
To register your intention to participate while payment is being processed, you may fax this form to (302) 831-6335 or e-mail the information to ud-itue@udel.edu. Please note that PBL@UD cannot accept credit card payments.
Information on travel, accommodations, and restaurants is also available.
Note: There is no registration fee required for participants from the University of Delaware.Deadline for registration is December 15, 2011.
