Name _________________________________________________________________
Department ____________________________________________________________
Institution ______________________________________________________________
Institution address
________________________________________________________
________________________________________________________
Email _____________________ Telephone ______________________
The following information will help us in planning workshop activities.
Disciplinary Areas: _________________________________________________________________
Are you primarily interested in lab activities? _______ Classroom activities? _________
How familiar are you (5 = very, 1 = not at all) with PBL? _____ POGIL? _____ PLTL? ____
FEES: The registration fee for the conference is $595 which includes workshop materials and refreshment breaks. Participants assume responsibility for living accommodation, meals, and transportation. The fee is reduced to $495 for payment received by June 1. Please make checks payable to the University of Delaware.
Please return this form with payment to:
ITUE June Session 2011 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) 831-6398 or e-mail the information to ud-itue@udel.edu.
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 June 1, 2011.
