PFI OnCourse 4 Day Workshop Registration

Please complete the following questions to register for the 4 day OnCourse Workshop. Confirmation and additional workshop details will be provided approximately 1 month prior to event.

Question Title

* 1. Contact Information

Name

College/School

Role/Position/Program (Ex: Counselor, Science Faculty)

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

Question Title

* 2. I plan to attend the 4 day On Course Workshop on the following date and college:

April 11th-14th, 2017 at Southeast Community College

May 15th -18th, 2017 at Central Community College: Columbus Campus

July 17th-20th, 2017 at Central Community College: Grand Island Hall County UNL Extension Building

October 10th-13th, 2017 at Mid-plains: Ogallala Campus

Question Title

* 3. I have attended a prior On Course Workshop before attending the 4 day On Course Workshop (Check all that apply).

Yes, I have attended a 3 day On Course Workshop

Yes, I have attended a 2 day On Course Workshop

Yes, I have attended a 1 day On Course Workshop

No, Please contact Jill Sand at 402-437-2781 to discuss options.

Question Title

* 4. The purpose of PFI providing the 4 Day On Course Workshops across the state is to create a faculty network who will provide future On Course based professional development opportunities (for the next 3 years) within their own college/school. Are you willing to be part of the Nebraska OnCourse Faculty Network sharing OnCourse with other faculty and educators?

Yes, I am very interested in being part of the NE OnCourse Faculty Network and providing OnCourse with other faculty across the state over the next three years.

No, I am not able to be part of the NE OnCourse Faculty Network.

Maybe, I might be interested and would need more information and time to participate in the NE OnCourse Faculty Network.