Rose-Hulman: Making Academic Change Happen (MACH)--Application

The nation's top undergraduate
engineering, science, and mathematics college

Contact

Mackenzie Valandingham
Administrative Assistant & Conference Coordinator, IRPA
(812) 877-8655

Don Richards
Director of CPSE & Professor of Mechanical Engineering
(812) 877-8477

Making Academic Change Happen (MACH) Workshop Application

Making Academic Change Happen (MACH) Workshop
Rose-Hulman Institute of Technology
June 3-6, 2013

Thank you for your interest in the MACH Workshop. Please complete a separate application form for each individual attending. The deadline for applications is extended to May 3, 2013.

(* denotes required field)

Participant Information:
First Name*:
Last Name*:
Position*:
Institution*:
Address*:
City*:
State*:
Zip*:	Country:
Phone*:	Fax:
Email*:

* - Please ensure your email address is accurate and valid. An email confirmation will be sent to the email address above.

Type of Application*:	Faculty, Staff, Administrator Graduate Student Graduate Student Requesting MACH Change Agent Grant

Teams: (if you are applying for a team, please provide the following information)

Number of Members:
Names of Members:

Participant Background:

Experience in academia*. Please provide a brief description (100 words or less) of your experience in academia.

What I bring to the workshop*. Please provide a brief explanation (500 words or less) of the challenges, projects, and ideas that you would like to bring to the workshop. Your responses will allow us to better match you (and your institutional team, if applicable) with workshop facilitators for the MACH Workshop.