2013 Great Lakes Conference on Teaching & Learning Call for Proposals

Contact Information

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Please answer the following questions about yourself:

1. Name

Name First:
Last:

2. Affiliation

Affiliation Institution:
Department:

3. Mailing Address

Mailing Address Street Address:
City:
State:
Zip:

4. Contact Information

Contact Information Phone:
Email:
Fax (if no fax number, enter 0):

Please list any additional authors you would like to acknowledge in the fields provided below, including those who will not be presenting with you.

5. Co-Author #1 Information

Co-Author #1 Information Name:
Institution:

6. Co-Author #2 Information

Co-Author #2 Information Name:
Institution:

7. Co-Author #3 Information

Co-Author #3 Information Name:
Institution:

8. Co-Author #4 Information

Co-Author #4 Information Name:
Institution:

Please tell us if any of the co-authors you have listed above, or any other individuals, will be presenting at the conference with you. Select an answer in the field below.

9. Do you have any co-presenters you would like to add (maximum of 5)?

Do you have any co-presenters you would like to add (maximum of 5)? Yes