Sign up for the SELECTION workshop

First Name
Last Name
Position/Title
Institution
Courses/Levels Taught
Please provide a brief statement explaining your interest in this workshop:
 
Address
Email
Phone
  
Please let us know if you have any special dietary or physical requirements:
  
Computers will be provided, but participants are encouraged to bring their own. Will you bring a laptop computer?
  
A limited number of travel stipends are available.
Do you want to apply for a travel stipend?
If you answered 'yes', please provide the following information:
Starting Location