Participant Nomination Form

PARTICIPANT NOMINATION FORM Early Career Faculty Workshop November 8, 2017, 1:00 p.m. – 6:30 p.m. Marriott Marquis, Houston, Texas followed by a dinner with program coordinators at a location TBD To be completed by the Program Director/Chair (preferred) or self-nominated. Please complete a separate form for each nominee. Applications will be received on a rolling basis until space is filled but with a submission deadline of 5pm (EST) on September 15, 2017. To apply, please email the application to [email protected]. If paying by credit card, a link to pay will be mailed to you once you have been accepted to the program. If paying by check, please mail your check along with a copy of the application to: ASHE Early Career Faculty Workshop / Box 453068 / 4505 S. Maryland Parkway /Las Vegas, NV. 89154-3068. Payment must be received before a participant will be considered registered to the workshop. PARTICIPANT NOMINEE INFORMATION Nominee name: Institution: Title: Department/Program: Work address: City: State: Zip code: Work phone: Fax: E-mail: Nominee is: A pre-tenured faculty member An administrator who has recently joined the faculty at any rank An advanced doctoral student with an accepted dissertation proposal (Must be nominated by their major professor.)

In the space below, briefly describe how you see the nominee benefiting from this workshop (i.e., speak to where they are in their career, what kinds of responsibilities they currently have in their position, what you would hope they would gain by participating). NOMINATOR INFORMATION Name: Title: Work Address: City: State: Zip code: Phone: Fax: E-mail:

Will you be joining your nominee for the dinner honoring the Early Career Faculty workshop participants on Wednesday November 8, 2017 at a local restaurant, immediately following the workshop?

Yes, I will attend (please add an additional $35.00 to your total). No, I am unable to attend.

Workshop Cost: $115 for ASHE Members, $140 for non-ASHE members Dinner Cost: Free for workshop participants, $35/per person for nominator and/or other faculty member(s).

PAYMENT METHOD (check one) Sorry, purchase orders will not be accepted.

Credit Card: (registration link for payment will be sent with acceptance notification).

Check:

Total Payment Amount: $

Questions on the workshop can be directed to Heather Rowan-Kenyon, [email protected].

1 Nominators are encouraged to join their nominees and other members of the Higher Education community including program coordinators for a dinner honoring the Early Career Faculty workshop participants. The cost for the dinner for nominators and other non-CAHEP early career faculty participants is $35.00—based on availability.

The CAHEP Early Career Workshop fee covers the CAHEP Thursday Pre-conference for workshop participants.