Clinical Faculty Academy- Participant Registration
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1.
Session
(Required.)
April 3-4, 2025 in Charleston, SC (Trident Technical College- Thornley Campus)
May 15-16, 2025 in Florence, SC (Florence-Darlington Technical College- Health Sciences Building)
July 31- August 1, 2025 in Myrtle Beach, SC (Horry-Georgetown Technical College- Grand Strand Campus)
September 25-26, 2025 in Rock Hill, SC (York Technical Colllege- Main Campus)
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2.
Name
(Required.)
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3.
Email
(Required.)
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4.
Cell Phone (only used to contact in case of emergency)
(Required.)
*
5.
Institution or Hospital Affiliation
(Required.)
*
6.
Job Title
(Required.)
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7.
Please select your highest level of education.
(Required.)
Associate Degree
Baccalaureate Degree
Master's Degree
Doctorate
Other (please specify)
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8.
Do you have any previous teaching experience?
(Required.)
Yes
No
If yes, please explain
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9.
How did you hear about the Clinical Faculty Academy?
(Required.)
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10.
Commitment Statement: I understand that there is no fee to participate in the Clinical Faculty Academy. However, I am committing to attendance for both days of the training.
(Required.)
Yes
No
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11.
Lunch will be provided by a sponsor both training days. If you have any food allergies or dietetic restrictions, please be prepared to bring your own lunch.
(Required.)
I understand lunch will be provided and should bring my own due to food allergies or dietetic restrictions.
I have no food allergies or dietetic restrictions.