* 1. Name

* 2. Email Address

* 3. University/Institution

* 4. Do you have any dietary restrictions?

* 5. Please indicate which days you will be attending (check all that apply)

* 6. Please indicate which meals you will be attending (check all that apply)

* 7. If you would like to present a poster during the poster session, please list the title.

* 8. Would you like to share a favorite active learning strategy, activity, assignment or assessment? These are short (10-15 minutes), interactive demonstrations with a small group. If you choose yes or maybe, we will follow up with you a few weeks before the meeting.