ACS 2017 COAChing Strategic Performance

Full Name *

Preferred Name

For name tags and tent cards

Attendee Type *

Assistant Professor

Associate Professor

OtherOther

Current Institution (employer) and position *

Please include address of institution

Email Address *

Apply for Travel Scholarship? *

Yes

For Academic applicants: up to $1,000 for airfare, 2 nights hotel

Have you previously attended a COACh Workshop? If so, which one? *

Why are you interested in attending this workshop? What do you hope to learn? *

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