C3 Summit 2014 – Registration

You should have received the link to this page from your school’s main C3 contact point (listed here). If not, please find out more about the 2014 Summit here

In order to help inform the work of C3 and best prepare for the Summit, please complete the following form.

PLEASE NOTE: The last day to register for the C3 Summit is March 12, 2014.

General information about the Summit can be found here.
A draft of the program is available here.
Information about accommodation and transportation here.

[contact-form][contact-field label=’First Name’ type=’text’ required=’1’/][contact-field label=’Last name’ type=’text’ required=’1’/][contact-field label=’Email’ type=’email’ required=’1’/][contact-field label=’Home institution’ type=’text’ required=’1’/][contact-field label=’Position’ type=’select’ required=’1′ options=’Undergraduate student,Graduate student / recent doctoral graduate,Faculty,Administrator / staff,Other’/][contact-field label=’If Faculty%26#x002c; Administrator%26#x002c; Staff: Position / Title?’ type=’text’/][contact-field label=’If student/recent graduate: Graduation year?’ type=’select’ options=’-,2012,2013,2014,2015,2016,2017,2018,2019,2020’/][contact-field label=’Academic department or program’ type=’text’/][contact-field label=’Study major / main research interest’ type=’text’/][contact-field label=’What do you hope to learn and/or achieve by attending the Summit?’ type=’textarea’/][contact-field label=’Are you engaged at your campus/community in role(s) where you are working to support others%26#039; success%26#x002c; advance change%26#x002c; and/or another leadership role? Please state how and in what capacity.’ type=’textarea’/][contact-field label=’If you could work on one issue to improve access and success for diverse groups on your campus%26#x002c; what would it be? Explain briefly. ‘ type=’textarea’/]
We hope you will be able to attend the full event.
Which days and meals will you be attending?

[contact-field label=’Friday%26#x002c; March 28%26#x002c; 2014′ type=’checkbox’/][contact-field label=’Saturday%26#x002c; March 29%26#x002c; 2014′ type=’checkbox’/][contact-field label=’Sunday%26#x002c; March 30%26#x002c; 2014′ type=’checkbox’/][contact-field label=’I am interested in taking a Campus Tour at 4 p.m. on Friday%26#x002c; March 28%26#x002c; 2014′ type=’checkbox’/][contact-field label=’I will attend the 5:30 p.m. reception on Friday’ type=’checkbox’/][contact-field label=’I will attend dinner on Friday’ type=’checkbox’/][contact-field label=’I will attend lunch on Saturday’ type=’checkbox’/][contact-field label=’I will attend dinner on Saturday’ type=’checkbox’/][contact-field label=’I would like a boxed lunch to go on Sunday’ type=’checkbox’/]

[contact-field label=’Check if you would prefer vegetarian meals’ type=’checkbox’/][contact-field label=’Please list any special ADA needs’ type=’textarea’/][/contact-form]

Answering questions on this form is voluntary. Your answers will be kept confidential and reported in aggregate form only.