Curriculum Development Workshop (Application)

1. Application Information

11% of survey complete.

Thank you for your interest in the COSEE-Ocean Systems Curriculum Development Workshop being held at Colby College on July 19-21.

Please complete the following application. Your information will be used to match you with a research scientist based on your interests, and will also be used to evaluate what you gained from attending this workshop.

Question Title

* Please provide some basic contact information.

Your Name: *

Name of Your School: *

Work Address:

City/Town:

State:

ZIP/Postal Code:

Email Address: *

Phone Number:

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* What is your gender?

Female

Male

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* What is your race/ethnicity? Please check all that apply:

American Indian or Alaskan Native

Asian

Black or African American (not of Hispanic origin)

Hawaiian Native or Pacific Islander

Hispanic or Latino

White or Caucasian (not of Hispanic origin)

Other

Other (please specify)