Arizona Cooperative Extension Teaching Workshop Registration

* Name:
* Unit/Location:
* Title:
* Email:

* I will attend the Teaching Workshop, April 1,
  10:00 am - 5:00 pm:
* I will attend the Teaching Workshop, April 2,
  8:30 am - 12:00 pm:
* Please indicate if you are faculty or staff:

Yes | No

Yes | No


Faculty | Staff

For Faculty:
Funding is limited, so lodging is on a first come first served basis. Lodging will be paid for if sharing a room with another faculty. Faculty requesting a single room, or sharing with a non-faculty/staff, will be billed for half of the room cost. Also, lodging will be paid only for those living outside the Tucson area.

For Staff:
Staff are welcome and encouraged to attend; however, due to a limited budget, your office will need to pay your expenses including lodging. For staff sharing a room with a faculty member, half the cost must be billed to your office. Staff requesting a single room or sharing with a non-faculty/staff must pay half the room cost themselves.

* I will need lodging the night of April 1:

Yes | No

If Yes, I:
    request a single room:
    will share with non-Faculty/Staff:
    need a roommate; please select one for me.
    will share a room with:

There is a $30.00 registration fee for both faculty and staff. Please ask your support staff to provide payment by IDB, by March 21, to:

   Arizona Cooperative Extension
   Forbes 301
   Tucson, AZ 85721-0036
   Attn: Patti Baciewicz

I acknowledge that there is a registration fee: