CO Sustainable Science & Green Chemistry Virtual Short Course Registration

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* 1. Contact Information

Name: *

School: *

School Address: *

Address 2:

City/Town: *

State:

ZIP: *

Country:

Email Address: *

Phone Number: *

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* 2. Rate your previous experience and knowledge of green chemistry. (1-unfamiliar with topic, 2-aware of topic, 3-neutral, 4-knowledgeable 5-very knowledgeable)

1- unfamiliar

2- aware of topic

3- somewhat knowledgeable

4-knowledgeable

5- very knowledgeable

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* 3. Please describe why you’d like to attend this training and who you would be willing to share your knowledge with upon completion of the workshop.

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* 4. Please describe in 500 words or less what you’d like to bring back to your students as a result of this training.

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* 5. How did you hear about the course?

COPHE

CAST

colleague

social media

Beyond Benign

Other (please specify)