2016 Kentucky Pedagogicon Funding Application — University of Louisville Delphi Center for Teaching and Learning

When
Friday, May 20

8 a.m. – 4:15 p.m.

Where
Eastern Kentucky University’s Noel Studio for Academic Creativity
Crabbe Library
521 Lancaster Avenue
Richmond, KY 40475

Faculty and staff should submit this form no later than Friday, April 15, 2016

Prefix

First Name

Last Name

Position/Department

City

State

Zip

Cell Phone Number

E-Mail Address

Special Dietary Needs (if so, please put details in comments field below)?

Pursuant to the Americans with Disabilities Act, do you require specific aids or services?

Yes I attended the Kentucky Pedagogicon Conference last year.

No I did not attend the Kentucky Pedagogicon Conference last year.

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